Cobalt-chromium toxicity following revision of total hip replacement

Authors

• Ramy Samargandi, From the Department of Orthopedic Surgery and Traumatology (Samargandi, Le Nail, Saad), The Regional University Hospital Centre of Tours, Tours, France, and from the Department of Orthopedic Surgery (Samargandi, Hetaimish), College of Medicine, University of Jeddah, Jeddah, Kingdom of Saudi Arabia.
• Louis-Romée Le Nail, From the Department of Orthopedic Surgery and Traumatology (Samargandi, Le Nail, Saad), The Regional University Hospital Centre of Tours, Tours, France, and from the Department of Orthopedic Surgery (Samargandi, Hetaimish), College of Medicine, University of Jeddah, Jeddah, Kingdom of Saudi Arabia.
• Bandar Hetaimish, From the Department of Orthopedic Surgery and Traumatology (Samargandi, Le Nail, Saad), The Regional University Hospital Centre of Tours, Tours, France, and from the Department of Orthopedic Surgery (Samargandi, Hetaimish), College of Medicine, University of Jeddah, Jeddah, Kingdom of Saudi Arabia.
• Maxime Saad, From the Department of Orthopedic Surgery and Traumatology (Samargandi, Le Nail, Saad), The Regional University Hospital Centre of Tours, Tours, France, and from the Department of Orthopedic Surgery (Samargandi, Hetaimish), College of Medicine, University of Jeddah, Jeddah, Kingdom of Saudi Arabia.

Abstract

Systemic cobalt-chromium (Co-Cr) toxicity following a total hip replacement is a rare complication that may sometimes lead to fatal consequences. We report a case of a 64-year-old woman, who presented with Co-Cr toxicity after revision of fractured ceramic components with metal-on-polyethylene. Systemic toxicity occurred a year after surgery and was expressed brutally with mostly central neurological symptoms. Revision surgery allowed rapid regression of all symptoms. Prosthetic revision with a metal bearing surface after a history of fracture of the ceramic bearing component should be avoided. Orthopedic surgeons and the different medical actors should be aware of this rare but serious complication to allow earlier management. Above all, multidisciplinary management is primordial to allow correct diagnosis and appropriate treatment.

Article Type

Case Report

First Page

194

Last Page

198

Recommended Citation

Samargandi, Ramy; Nail, Louis-Romée Le; Hetaimish, Bandar; and Saad, Maxime (2024) "Cobalt-chromium toxicity following revision of total hip replacement," Saudi Medical Journal: Vol. 45: Iss. 2, Article 12.
DOI: https://doi.org/10.15537/smj.2024.45.2.20230334