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Arthroprosthetic cobaltism associated with cardiomyopathy
Ryan S Charette1, Alexander L Neuwirth1, Charles L Nelson1
1Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA.
Arthroplasty Today
|December 6, 2017
Summary
Systemic cobaltism from metal-on-metal hip implants can harm multiple organs. Revision surgery to non-cobalt implants improved cardiac function in a patient with cardiomyopathy.
Area of Science:
- Orthopedic Surgery
- Cardiology
- Toxicology
Background:
- Metal-on-metal total hip arthroplasty (MOM THA) has been associated with systemic cobaltism.
- Cobalt toxicity can affect cardiac, neurologic, endocrine, and immunologic systems.
Observation:
- A 46-year-old male with bilateral MOM THA developed cardiomyopathy.
- The patient required left ventricular assist device implantation due to cardiac dysfunction.
Findings:
- Revision surgery to bilateral non-cobalt-containing implants led to improved cardiac function.
- This case highlights a rare but severe complication of MOM THA.
Implications:
- Early recognition and intervention are crucial for managing cobaltism following MOM THA.
- Revision arthroplasty can be an effective treatment for cardiac complications.
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