Cobalt intoxication: mitochondrial features and condition

Cobalt intoxication is a rare complication of joint arthroplasty with a metal-on-metal prothesis or metal implants after broken ceramic implants. Patients with metal components should be monitored closely for complications. The awareness for the wide range of clinical pictures of this cobalt intoxication should be increased. We here describe the clinical presentation, diagnostic and therapeutic work-up of a 70-year-old patient with a cobalt metallosis. The patient presented with a progressive deterioration of vision and hearing, axonal sensorimotor polyneuropathy and cataract. The extensive work-up resulted in the diagnosis of a cobalt metallosis as a complication of a metal hip prosthesis. Cobalt intoxication, especially after metal-on-metal total joint arthroplasty, is a rare complication; however, there have been several reports of similar cases. It is therefore recommended to avoid the implantation of a metal-on-metal prothesis or metal implants after broken ceramic implants as in this case whenever possible. Patients with exclusively metal components should be monitored closely for complications.