Cobalt cardiomyopathy in hip arthroplasty
Background: Cobalt toxicity-related cardiomyopathy in hip arthroplasty has recently been reported in the literature. The purpose of this review is to identify and assess available published evidence of cardiomyopathy in hip arthroplasty patients and to derive recommendations for management. Methods:...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2019-09-01
|
| Series: | Arthroplasty Today |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344119300433 |
| _version_ | 1818600899986063360 |
|---|---|
| author | Muhammad Umar, BSc, MBBS, DipSEM, FRCS Noman Jahangir, MBBS, FRCS Muhammad Faisal Khan, MBBS, FRCS Zobia Saeed, MBBS, MSc Farina Sultan, MBBS, MSc Ayyaz Sultan, MBBS, FRCP, FACC, FAHA |
| author_facet | Muhammad Umar, BSc, MBBS, DipSEM, FRCS Noman Jahangir, MBBS, FRCS Muhammad Faisal Khan, MBBS, FRCS Zobia Saeed, MBBS, MSc Farina Sultan, MBBS, MSc Ayyaz Sultan, MBBS, FRCP, FACC, FAHA |
| author_sort | Muhammad Umar, BSc, MBBS, DipSEM, FRCS |
| collection | DOAJ |
| description | Background: Cobalt toxicity-related cardiomyopathy in hip arthroplasty has recently been reported in the literature. The purpose of this review is to identify and assess available published evidence of cardiomyopathy in hip arthroplasty patients and to derive recommendations for management. Methods: We evaluated 23 cases reported until October 2018 and stratified them into 3 categories, based upon pre-existing risk factors for cardiomyopathy, histological confirmation, and evidence of systemic signs of cobalt toxicity. Results: Cobalt toxicity was considered to be the definite cause of cardiomyopathy in 8 cases, and probably contributory in 13 cases. Two cases were considered to have developed cardiomyopathy secondary to pre-existing risk factors. Majority of the patients had a good recovery of cardiac function after hip revision and cardiac management, but 5 cases deteriorated and died. Conclusions: Although cobalt-related cardiomyopathy has been reported in a small number of cases of hip arthroplasty, a delay or missed diagnosis may lead to significant morbidity and mortality. Timely diagnosis, removal of causative implant, and avoidance of metal articulations in revision for fractured ceramic implants may help in an effective management. Keywords: Cardiomyopathy, Cobalt, Metal-on-metal, Hip arthroplasty, Toxicity |
| first_indexed | 2024-12-16T12:42:50Z |
| format | Article |
| id | doaj.art-e9c28318ed834c6b8f3fd3c634620177 |
| institution | Directory Open Access Journal |
| issn | 2352-3441 |
| language | English |
| last_indexed | 2024-12-16T12:42:50Z |
| publishDate | 2019-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj.art-e9c28318ed834c6b8f3fd3c6346201772022-12-21T22:31:22ZengElsevierArthroplasty Today2352-34412019-09-0153371375Cobalt cardiomyopathy in hip arthroplastyMuhammad Umar, BSc, MBBS, DipSEM, FRCS0Noman Jahangir, MBBS, FRCS1Muhammad Faisal Khan, MBBS, FRCS2Zobia Saeed, MBBS, MSc3Farina Sultan, MBBS, MSc4Ayyaz Sultan, MBBS, FRCP, FACC, FAHA5Department of Trauma and Orthopaedics, Macclesfield District General Hospital, Macclesfield, UK; Corresponding author. Department of Trauma & Orthopaedics, Macclesfield District General Hospital, Macclesfield SK10 3BL, UK. Tel.: +44 786 793 4053.Department of Trauma and Orthopaedics, Wythenshawe Hospital, Manchester, UKDepartment of Urology, North Devon District General Hospital, Barnstaple, UKDepartment of Trauma and Orthopaedics, Macclesfield District General Hospital, Macclesfield, UKDepartment of Cardiology, Royal Albert Edward Infirmary Wrightington, Wigan & Leigh NHS Foundation Trust, Wigan, UKDepartment of Cardiology, Royal Albert Edward Infirmary Wrightington, Wigan & Leigh NHS Foundation Trust, Wigan, UKBackground: Cobalt toxicity-related cardiomyopathy in hip arthroplasty has recently been reported in the literature. The purpose of this review is to identify and assess available published evidence of cardiomyopathy in hip arthroplasty patients and to derive recommendations for management. Methods: We evaluated 23 cases reported until October 2018 and stratified them into 3 categories, based upon pre-existing risk factors for cardiomyopathy, histological confirmation, and evidence of systemic signs of cobalt toxicity. Results: Cobalt toxicity was considered to be the definite cause of cardiomyopathy in 8 cases, and probably contributory in 13 cases. Two cases were considered to have developed cardiomyopathy secondary to pre-existing risk factors. Majority of the patients had a good recovery of cardiac function after hip revision and cardiac management, but 5 cases deteriorated and died. Conclusions: Although cobalt-related cardiomyopathy has been reported in a small number of cases of hip arthroplasty, a delay or missed diagnosis may lead to significant morbidity and mortality. Timely diagnosis, removal of causative implant, and avoidance of metal articulations in revision for fractured ceramic implants may help in an effective management. Keywords: Cardiomyopathy, Cobalt, Metal-on-metal, Hip arthroplasty, Toxicityhttp://www.sciencedirect.com/science/article/pii/S2352344119300433 |
| spellingShingle | Muhammad Umar, BSc, MBBS, DipSEM, FRCS Noman Jahangir, MBBS, FRCS Muhammad Faisal Khan, MBBS, FRCS Zobia Saeed, MBBS, MSc Farina Sultan, MBBS, MSc Ayyaz Sultan, MBBS, FRCP, FACC, FAHA Cobalt cardiomyopathy in hip arthroplasty Arthroplasty Today |
| title | Cobalt cardiomyopathy in hip arthroplasty |
| title_full | Cobalt cardiomyopathy in hip arthroplasty |
| title_fullStr | Cobalt cardiomyopathy in hip arthroplasty |
| title_full_unstemmed | Cobalt cardiomyopathy in hip arthroplasty |
| title_short | Cobalt cardiomyopathy in hip arthroplasty |
| title_sort | cobalt cardiomyopathy in hip arthroplasty |
| url | http://www.sciencedirect.com/science/article/pii/S2352344119300433 |
| work_keys_str_mv | AT muhammadumarbscmbbsdipsemfrcs cobaltcardiomyopathyinhiparthroplasty AT nomanjahangirmbbsfrcs cobaltcardiomyopathyinhiparthroplasty AT muhammadfaisalkhanmbbsfrcs cobaltcardiomyopathyinhiparthroplasty AT zobiasaeedmbbsmsc cobaltcardiomyopathyinhiparthroplasty AT farinasultanmbbsmsc cobaltcardiomyopathyinhiparthroplasty AT ayyazsultanmbbsfrcpfaccfaha cobaltcardiomyopathyinhiparthroplasty |