Cardiac transplant due to metal toxicity associated with hip arthroplasty
Concerns regarding metal-on-metal (MoM) bearing couples in total hip arthroplasty are well documented in the literature with cobalt (Co) and chromium (Cr) toxicity causing a range of both local and systemic adverse reactions. We describe the case of a patient undergoing cardiac transplantation as a...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2017-09-01
|
| Series: | Arthroplasty Today |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344117300055 |
| _version_ | 1811225743759245312 |
|---|---|
| author | Sheldon Moniz, MBBS (UWA) Sean Hodgkinson, MBBS (UWA) Piers Yates, MBBS (Hons), BSc (Hons), MRCS (Eng), FRCS (Tr & Orth), FRACS (Ortho), FAOrthA |
| author_facet | Sheldon Moniz, MBBS (UWA) Sean Hodgkinson, MBBS (UWA) Piers Yates, MBBS (Hons), BSc (Hons), MRCS (Eng), FRCS (Tr & Orth), FRACS (Ortho), FAOrthA |
| author_sort | Sheldon Moniz, MBBS (UWA) |
| collection | DOAJ |
| description | Concerns regarding metal-on-metal (MoM) bearing couples in total hip arthroplasty are well documented in the literature with cobalt (Co) and chromium (Cr) toxicity causing a range of both local and systemic adverse reactions. We describe the case of a patient undergoing cardiac transplantation as a direct result of Co and Cr toxicity following a MoM hip replacement. Poor implant positioning led to catastrophic wear generating abundant wear particles leading to Co and Cr toxicity, metallosis, bony destruction, elevated metal ion levels, and adverse biological responses. Systemic symptoms continued for 3 years following cardiac transplantation with resolution only after revision hip arthroplasty. There was no realization in the initial cardiac assessment and subsequent transplant workup that the hip replacement was the likely cause of the cardiac failure, and the hip replacement was not recognized as the cause until years after the heart transplant. This case highlights the need for clinicians to be aware of systemic MoM complications as well as the importance of positioning when using these prostheses. |
| first_indexed | 2024-04-12T09:12:34Z |
| format | Article |
| id | doaj.art-5d24e39230b447789eef8e098414cf74 |
| institution | Directory Open Access Journal |
| issn | 2352-3441 |
| language | English |
| last_indexed | 2024-04-12T09:12:34Z |
| publishDate | 2017-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj.art-5d24e39230b447789eef8e098414cf742022-12-22T03:38:55ZengElsevierArthroplasty Today2352-34412017-09-013315115310.1016/j.artd.2017.01.005Cardiac transplant due to metal toxicity associated with hip arthroplastySheldon Moniz, MBBS (UWA)Sean Hodgkinson, MBBS (UWA)Piers Yates, MBBS (Hons), BSc (Hons), MRCS (Eng), FRCS (Tr & Orth), FRACS (Ortho), FAOrthAConcerns regarding metal-on-metal (MoM) bearing couples in total hip arthroplasty are well documented in the literature with cobalt (Co) and chromium (Cr) toxicity causing a range of both local and systemic adverse reactions. We describe the case of a patient undergoing cardiac transplantation as a direct result of Co and Cr toxicity following a MoM hip replacement. Poor implant positioning led to catastrophic wear generating abundant wear particles leading to Co and Cr toxicity, metallosis, bony destruction, elevated metal ion levels, and adverse biological responses. Systemic symptoms continued for 3 years following cardiac transplantation with resolution only after revision hip arthroplasty. There was no realization in the initial cardiac assessment and subsequent transplant workup that the hip replacement was the likely cause of the cardiac failure, and the hip replacement was not recognized as the cause until years after the heart transplant. This case highlights the need for clinicians to be aware of systemic MoM complications as well as the importance of positioning when using these prostheses.http://www.sciencedirect.com/science/article/pii/S2352344117300055ArthroplastyComplicationsHeart transplantCobaltChromiumToxicity |
| spellingShingle | Sheldon Moniz, MBBS (UWA) Sean Hodgkinson, MBBS (UWA) Piers Yates, MBBS (Hons), BSc (Hons), MRCS (Eng), FRCS (Tr & Orth), FRACS (Ortho), FAOrthA Cardiac transplant due to metal toxicity associated with hip arthroplasty Arthroplasty Today Arthroplasty Complications Heart transplant Cobalt Chromium Toxicity |
| title | Cardiac transplant due to metal toxicity associated with hip arthroplasty |
| title_full | Cardiac transplant due to metal toxicity associated with hip arthroplasty |
| title_fullStr | Cardiac transplant due to metal toxicity associated with hip arthroplasty |
| title_full_unstemmed | Cardiac transplant due to metal toxicity associated with hip arthroplasty |
| title_short | Cardiac transplant due to metal toxicity associated with hip arthroplasty |
| title_sort | cardiac transplant due to metal toxicity associated with hip arthroplasty |
| topic | Arthroplasty Complications Heart transplant Cobalt Chromium Toxicity |
| url | http://www.sciencedirect.com/science/article/pii/S2352344117300055 |
| work_keys_str_mv | AT sheldonmonizmbbsuwa cardiactransplantduetometaltoxicityassociatedwithhiparthroplasty AT seanhodgkinsonmbbsuwa cardiactransplantduetometaltoxicityassociatedwithhiparthroplasty AT piersyatesmbbshonsbschonsmrcsengfrcstrorthfracsorthofaortha cardiactransplantduetometaltoxicityassociatedwithhiparthroplasty |