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Metallosis following full thickness wear in total hip arthroplasty

Extreme wear through the metal-backed acetabular cup following total hip arthroplasty is rare, as symptoms such as pain and disability will usually manifest earlier. We present the second reported case of extreme wear in a 78-year-old male patient, who presented 20 years following an uncemented tota...

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Autores principales: Birkett, Nicholas, El-Daly, Ibraheim, Ibraheim, Hajir, Mbubaegbu, Chima
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4577831/
https://www.ncbi.nlm.nih.gov/pubmed/26395872
http://dx.doi.org/10.1093/jscr/rjv122
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author Birkett, Nicholas
El-Daly, Ibraheim
Ibraheim, Hajir
Mbubaegbu, Chima
author_facet Birkett, Nicholas
El-Daly, Ibraheim
Ibraheim, Hajir
Mbubaegbu, Chima
author_sort Birkett, Nicholas
collection PubMed
description Extreme wear through the metal-backed acetabular cup following total hip arthroplasty is rare, as symptoms such as pain and disability will usually manifest earlier. We present the second reported case of extreme wear in a 78-year-old male patient, who presented 20 years following an uncemented total hip replacement with a 3-year history of hip pain, clicking on ambulation and worsening mobility. Radiographs demonstrated that the femoral head had migrated superolaterally through the polyethylene liner and the acetabular cup, and was articulating with the superior wall of the acetabulum causing bony destruction. Metallic fragments were also evident. A review of the current literature on metallosis suggests that should there be any clinical suspicion, blood metal ion levels are monitored and an MARS-MRI scan performed if indicated. If metallosis is detected, then revision surgery can be attempted at an earlier date, where the procedure is not as technically difficult.
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spelling pubmed-45778312015-09-24 Metallosis following full thickness wear in total hip arthroplasty Birkett, Nicholas El-Daly, Ibraheim Ibraheim, Hajir Mbubaegbu, Chima J Surg Case Rep Case Reports Extreme wear through the metal-backed acetabular cup following total hip arthroplasty is rare, as symptoms such as pain and disability will usually manifest earlier. We present the second reported case of extreme wear in a 78-year-old male patient, who presented 20 years following an uncemented total hip replacement with a 3-year history of hip pain, clicking on ambulation and worsening mobility. Radiographs demonstrated that the femoral head had migrated superolaterally through the polyethylene liner and the acetabular cup, and was articulating with the superior wall of the acetabulum causing bony destruction. Metallic fragments were also evident. A review of the current literature on metallosis suggests that should there be any clinical suspicion, blood metal ion levels are monitored and an MARS-MRI scan performed if indicated. If metallosis is detected, then revision surgery can be attempted at an earlier date, where the procedure is not as technically difficult. Oxford University Press 2015-09-22 /pmc/articles/PMC4577831/ /pubmed/26395872 http://dx.doi.org/10.1093/jscr/rjv122 Text en Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2015. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Case Reports
Birkett, Nicholas
El-Daly, Ibraheim
Ibraheim, Hajir
Mbubaegbu, Chima
Metallosis following full thickness wear in total hip arthroplasty
title Metallosis following full thickness wear in total hip arthroplasty
title_full Metallosis following full thickness wear in total hip arthroplasty
title_fullStr Metallosis following full thickness wear in total hip arthroplasty
title_full_unstemmed Metallosis following full thickness wear in total hip arthroplasty
title_short Metallosis following full thickness wear in total hip arthroplasty
title_sort metallosis following full thickness wear in total hip arthroplasty
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4577831/
https://www.ncbi.nlm.nih.gov/pubmed/26395872
http://dx.doi.org/10.1093/jscr/rjv122
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