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Metallosis Identified via Intraoperative Cell Salvage: A Case Report
Lauren M Parker1, Mark H Yazer, Jonathan H Waters
1From the *University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; †Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; ‡The Institute for Transfusion Medicine, Pittsburgh, Pennsylvania; §Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; and ‖The McGowan Institute for Regenerative Medicine, Pittsburgh, Pennsylvania.
Intraoperative cell salvage, whereby shed surgical blood is recovered for autologous reinfusion, is frequently used during hip arthroplasty because of the potential for significant blood loss. The following cases describe 2 instances in which chromium and cobalt particles from patients' metal-on-metal hip implants were identified within the blood recovery system. Results of heavy metal testing during the second case suggest that the use of a leukocyte reduction filter effectively reduces metal concentrations to below normal circulating levels. However, the reinfusion of cell salvage blood containing obvious metallic particles cannot be recommended until the effectiveness of leukocyte reduction filters in removing heavy metals has been further tested.
Intraoperative cell salvage, whereby shed surgical blood is recovered for autologous reinfusion, is frequently used during hip arthroplasty because of the potential for significant blood loss. The following cases describe 2 instances in which chromium and cobalt particles from patients' metal-on-metal hip implants were identified within the blood recovery system. Results of heavy metal testing during the second case suggest that the use of a leukocyte reduction filter effectively reduces metal concentrations to below normal circulating levels. However, the reinfusion of cell salvage blood containing obvious metallic particles cannot be recommended until the effectiveness of leukocyte reduction filters in removing heavy metals has been further tested.
