Related Experiment Video
Updated: Jan 19, 2026
09:31
Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
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Cobalt cardiomyopathy in hip arthroplasty
Muhammad Umar1, Noman Jahangir2, Muhammad Faisal Khan3
1Department of Trauma and Orthopaedics, Macclesfield District General Hospital, Macclesfield, UK.
Arthroplasty Today
|September 14, 2019
Summary
Cobalt toxicity from hip arthroplasty can cause cardiomyopathy. Early diagnosis and implant removal are crucial for patient recovery, though some cases may still be fatal.
Area of Science:
- Orthopedic Surgery
- Cardiology
- Toxicology
Background:
- Cobalt toxicity-related cardiomyopathy is an emerging concern in hip arthroplasty patients.
- Literature reports highlight the association between metal-on-metal hip implants and systemic cobalt toxicity.
- This review focuses on understanding and managing this specific type of cardiomyopathy.
Purpose of the Study:
- To systematically review and evaluate published evidence of cardiomyopathy in hip arthroplasty recipients.
- To identify risk factors, diagnostic criteria, and management strategies for cobalt toxicity-induced cardiomyopathy.
- To formulate evidence-based recommendations for clinical practice.
Main Methods:
- A comprehensive literature search was conducted to identify relevant cases up to October 2018.
- Twenty-three cases of cobalt toxicity-related cardiomyopathy were analyzed.
- Cases were stratified based on pre-existing cardiac risk factors, histological findings, and systemic cobalt toxicity indicators.
Main Results:
- Cobalt toxicity was identified as the definite cause in 8 cases and a probable contributor in 13 cases.
- Two cases developed cardiomyopathy secondary to pre-existing conditions.
- Most patients recovered cardiac function after hip revision and treatment, but 5 cases resulted in mortality.
Conclusions:
- Delayed diagnosis or management of cobalt-related cardiomyopathy can lead to severe outcomes.
- Prompt diagnosis, removal of the offending implant, and appropriate cardiac care are essential.
- Avoiding metal articulations during revision surgery for fractured ceramic implants is recommended to prevent recurrence.
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