Granulomatous Lung Disease: A Novel Complication following Metallosis from Hip Arthroplasty

Hip Pelvis. 2016 Dec;28(4):249-253. doi: 10.5371/hp.2016.28.4.249. Epub 2016 Dec 28.

Abstract

A case of a female patient with local and systemic complications of metallosis, following catastrophic wear of a revised hip arthroplasty, is presented. The patient had a history of a fractured ceramic-on-ceramic implant, exchanged with a metal-on-polyethylene prosthesis. Systemic complications included sarcoidosis-like reactions, presenting as granulomatous lung disease, along with chorioretinitis, erythema nodosum, and cardiomyopathy. High local and circulating cobalt and chromium levels established the diagnosis. The patient underwent extensive debridement and implant revision. One year postoperatively, she had no respiratory symptoms or functional impairment. Local and systemic complications of metallosis after hip arthroplasty should be promptly recognized and treated operatively.

Keywords: Ceramics; Heavy metal toxicity; Hip replacement arthroplasty; Pulmonary sarcoidosis; Reoperation.

Publication types

  • Case Reports