Kantonsspital St.Gallen
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Massive wear of an incompatible metal-on-metal articulation in total hip arthroplasty

Johannes B Keel & Markus Kuster

abstract We report on a case of massive wear because of an incompatible metal-on-metal combination. In a 62-year-old man, a cobalt-chromium (CoCr) inlay and a stainless steel head were paired by accident. Because of persistent pain, revision surgery was performed 7 months later. Histologic analysis of the surrounding tissue revealed massive metallosis. The wear volume was increased by a factor of 18 for the head and 2 for the cup compared with normal metal-on-metal articulation. The serum concentrations of chromium and cobalt were increased by a factor of 20 and 4 over levels of a healthy population, respectively. Incompatible metal-on-metal combinations should be revised immediately. In case of delayed diagnosis, no metal-on-metal articulation should be implanted because of the high volume of metal in the human body.
   
citation Keel J B, kuster m. Massive wear of an incompatible metal-on-metal articulation in total hip arthroplasty. The Journal of arthroplasty 2004; 19:638-42.
   
type journal paper/review (English)
date of publishing 8-2004
journal title The Journal of arthroplasty (19/5)
ISSN print 0883-5403
pages 638-42
PubMed 15284987