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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
PubMed

Insights

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.

Keywords:
CardiomyopathyCobaltismMetal-on-metal total hip arthroplasty

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