63-year-old woman with hip prosthesis, asthenia, headaches and hypothyroidism

Authors

  • Jorge Salvador-Marín Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario de San Juan. Alicante. España
  • Francisco Javier Ferrández-Martínez Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario de San Juan. Alicante. España
  • Aarón Gutiérrez-Pastor Servicio de Medicina Interna. Hospital Universitario de San Juan. Alicante. España
  • José Fernando Martínez-López Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario de San Juan. Alicante. España
  • José Miguel Seguí-Ripoll Servicio de Medicina Interna. Hospital Universitario de San Juan. Alicante. España https://orcid.org/0000-0002-3574-3619

DOI:

https://doi.org/10.32818/reccmi.a4n2a12

Keywords:

metalosis, hip prosthesis, inflammatory pseudotumor, cobalt.

Abstract

Patients undergoing hip replacement using the metal-metal friction pair can develop local or systemic pathologies related to the release of Cobalt and Chromium particles by the continuous rubbing of its metallic surfaces. This phenomenon called metallosis is important to keep in mind the diagnosis of suspicious to know the pathologies produced by this metallosis and in these cases, request a serum determination of Cobalt and Chromium. The treatment of symptomatic metallosis consists of prosthetic removal and replacement, achieving a decrease in the blood concentrations of these metals and an improvement of the systemic clinical picture. We present a female carrier of hip arthroplasty evaluated in Internal Medicine for chronic presentation asthenia, headaches, sensory disturbances (sight, hearing) and hypothyroidism.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Bradberry SM, Wilkinson JM, Ferner RE. Systemic toxicity related to metal hip prostheses. Clin Toxicol (Phila). 2014; 52(8): 837-847. doi: https://doi.org/10.3109/15563650.2014.944977.

Simonsen LO, Harbak H, Bennekou P. Cobalt metabolism and toxicology a brief update. Sci Total Environ. 2012; 432: 210-215. doi: https://doi.org/10.1016/j.scitotenv.2012.06.009.

Watters TS, Cardona DM, Menon KS, Vinson EN, Bolognesi MP, Dodd LG. Aseptic lymphocyte dominated vasculitis associated lesion: a clinico pathologic review of an underrecognized cause of prosthetic failure. Am J Clin Pathol. 2010; 134(6): 886-893. doi: https://doi.org/10.1309/AJCPLTNEUAH8XI4W.

Lainiala O, Reito A, Elo P, Pajamäki J, Puolakka T, Eskelinen A. Revision of metal-on-metal hip prostheses results in marked reduction of blood cobalt and chromium ion concentrations. Clin Orthop Relat Res. 2015; 473(7): 2305-2313. doi: https://doi.org/10.1007/s11999-015-4156-6.

Gallart X, Marín O. Información y asesoramiento para cirujanos ortopédicos: árbol de decisiones ante un paciente portador de prótesis con par de fricción metal-metal. Rev Esp Cir Ortop Traumatol. 2011; 55(1): 67-69. doi: https://doi.org/10.1016/j.recot.2010.12.007.

Morlock MM, Kunze J, Wimmer MA, Lohmann CH. Metal-on-metal: ion le- vels as an intervention strategy. Semin Arthroplasty. 2012; 23: 283-285. doi: https://doi.org/10.1053/j.sart.2012.12.002.

Cohen D. Revision rates for metal on metal hip joints are double that of other materials. BMJ. 2011; 343: d5977. doi: https://doi.org/10.1136/bmj.d5977.

Smith AJ, Dieppe P, Vernon K, et al; National Joint Registry of England and Wales. Failure rates of stemmed metal-on-metal hip replacements: analysis of data from the National Joint Registry of England and Wales. Lancet. 2012; 379(9822): 1199-1204. doi: https://doi.org/10.1016/S0140-6736(12)60353-5.

Published

2019-08-31

How to Cite

1.
Salvador-Marín J, Ferrández-Martínez FJ, Gutiérrez-Pastor A, Martínez-López JF, Seguí-Ripoll JM. 63-year-old woman with hip prosthesis, asthenia, headaches and hypothyroidism. Rev Esp Casos Clin Med Intern [Internet]. 2019 Aug. 31 [cited 2024 Jul. 3];4(2):76-8. Available from: https://www.reccmi.com/RECCMI/article/view/428