Letter to the Editor: How Do Serum Cobalt and Chromium Levels Change after Metal-on-Metal Hip Resurfacing?

2006 ◽  
Vol 451 ◽  
pp. 292-293 ◽  
Author(s):  
Pascal-A Vendittoli ◽  
Martin Lavigne ◽  
Alain-Guy Roy
Keyword(s):  
Hip Resurfacing ◽  
Letter To The Editor ◽  
Metal On Metal ◽  
Serum Cobalt

The Treatment of Femoral Neuropathy Due to Pseudotumour Caused by Metal-On-Metal Resurfacing Arthroplasty

2008 ◽  
Vol 18 (4) ◽  
pp. 313-320 ◽  
Author(s):  
P. Harvie ◽  
H. Giele ◽  
C. Fang ◽  
O. Ansorge ◽  
S. Ostlere ◽  
...  
Keyword(s):  
Wear Debris ◽  
Biological Effects ◽  
Hip Resurfacing ◽  
Pathological Process ◽  
Femoral Neuropathy ◽  
Resurfacing Arthroplasty ◽  
Metal On Metal ◽  
Metal Wear ◽  
Neurophysiological Studies ◽  
Serum Cobalt

Concerns now exist about the long-term biological effects of exposure to orthopaedic metal alloys, particularly serum cobalt and chromium ions derived from metal-on–metal wear debris in these patients. A pseudotumour mass complicating metal-on-metal resurfacing arthroplasty has been recognized by orthopaedic oncologists and specialist hip units. Pseudotumours may also present with a major nerve palsy. Two cases of femoral neuropathy due to pseudotumour masses caused by metal-on-metal resurfacing arthroplasty are presented. Preoperative neurophysiological studies showed severe and irreversible pathological changes to nerve function with neurohistopathological evidence of complete nerve destruction with a previously unreported pathological appearance. This may represent a previously unrecognized pathological process, possibly ‘toxic’ in nature, resulting from metal-on-metal wear debris. Prolonged follow-up and detailed clinical assessment of patients after hip resurfacing arthroplasty is advocated with planned and expeditious revision of any patient in whom evidence of femoral neuropathy develops.

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