Related Experiment Video
Updated: Jun 5, 2025
Potentiodynamic Corrosion Testing
Published on: September 4, 2016
Diagnostic Dilemma: Unusual Post-replacement Hip Pain Following Trauma Leading to Metallosis - A Case Report
Rajat Gupta1, Sanjay Singh Rawat2
1Department of Orthopaedics, ESI PGIMSR, Basaidarapur, New Delhi, India.
Introduction:
Metallosis, characterized by the collection of metallic debris in periarticular tissues, is primarily associated with metal-on-metal bearings in hip arthroplasty. This report presents a rare case of metallosis after metal-on-polyethylene (MoP) total hip arthroplasty (THA), highlighting diagnostic challenges and management strategies. Metallosis following MoP arthroplasty is extremely rare, with only a limited number of documented cases in the literature.
Case Report:
A 70-year-old man presented with post-traumatic hip pain and instability 6 years after an uncemented MoP THA. Radiographs revealed a fractured acetabular cup with metal fragments and displacement of the femoral head. A computed tomography scan confirmed liner failure, cup breakage, and radiodense opacities around the joint. Given the post-traumatic presentation and the risk of heterotopic ossification, the patient underwent revision surgery. Revision surgery involved acetabular component exchange, and clinical follow-up indicated satisfactory outcomes.
Conclusion:
This case highlights the atypical presentation of metallosis following MoP THA, emphasizing the significance of early diagnosis and awareness for optimal patient outcomes.
Insights
Metallosis, a rare complication after hip replacement with metal-on-polyethylene (MoP) bearings, occurred in a patient with a fractured acetabular cup. Early diagnosis and revision surgery led to satisfactory outcomes in this unique case.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Medical Imaging
Background:
- Metallosis, the accumulation of metallic debris, is typically linked to metal-on-metal hip implants.
- This report details an exceptionally rare instance of metallosis occurring after metal-on-polyethylene (MoP) total hip arthroplasty (THA).
Observation:
- A 70-year-old male experienced hip pain and instability six years post-MoP THA.
- Imaging revealed acetabular cup fracture, liner failure, and metal debris, complicating a post-traumatic presentation.
Findings:
- The patient underwent revision surgery due to component failure and metallosis.
- Surgical intervention involved acetabular component exchange, resulting in positive clinical outcomes.
Implications:
- This case underscores the importance of recognizing atypical metallosis presentations in MoP THA patients.
- Prompt diagnosis and surgical management are crucial for favorable outcomes in rare implant complications.
