The Hip and Knee Journal
Vol 2, No 2 (2021): August

Excellent Result of Revision Total Hip Replacement with Unexpected Metallosis

azmi farhadi (Airlangga University)
Kukuh Dwiputra Hernugrahanto (Unknown)
Jifaldiafrian Maharajadinda Sedar (Soetomo General Hospital - Medical Faculty UNAIR)
Mohammad Zaim Chilmi (Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Jl. Mayjend Prof. Dr. Moestopo No. 6-8, Airlangga)



Article Info

Publish Date
25 Aug 2021

Abstract

ABSTRACT Background: Metallosis is a syndrome of metal-induced synovitis with infiltration and accumulation of metallic debris into the periprosthetic structures, including soft and bony tissues. The debris causes a chronic inflammatory reaction due to joint instability, pain, osteolysis, implant loosening, or implant failure. The absence of a specific sign or symptom that indicates metallosis causes difficulty to diagnose.Presentation of Case: A 35-year-old female, history of primary left total hip replacement since seven years ago after avascular necrosis of the femoral head, presented with an eight-month history of left hip pain and limited range of motion. Radiograph results showed that there is no evidence of periprosthetic fracture or infection. The patient underwent a left revision total hip replacement, which revealed extensive necrotic black metal debris throughout the joint space.Discussion: Effective treatment requires a revision of total hip replacement to remove metal debris, bone graft area osteolysis, and to address the mechanical failure. The greatest possible of metallic debris during debridement is vital to avoid further osteolysis and prevent more extensive damage. Excellent clinical result was evaluated by Harris’s hip score in 18 months postoperatively.Conclusion: This case is a rare example of chronic metallosis presenting seven years following total hip replacement. Revision total hip replacement is the consensus management choice to avoid further destruction of the bone and joint capsule that can occur with metal-induced inflammation. Keywords: 

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Journal Info

Abbrev

hipknee

Publisher

Subject

Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Education Health Professions Neuroscience

Description

The journal publishes original research articles, review articles, case reports, and short communications. In addition, the regular content includes letters to the Editor and conference proceedings. Submitted papers must be written in English for an initial review stage by editors and further review ...