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Back to CIM Cases
ArthroplastyHip - Arthroplasty

Metal-on-Metal Hip Arthroplasty Failure

Arthroplasty
Intermediate
6 min
High Yield
loosening
6:00
Start the timer to simulate exam conditions

Metal-on-Metal Hip Arthroplasty Failure

Clinical Scenario

Patient with MoM hip presenting for surveillance or with symptoms

Questions & Model Answers

Q1

How do you stratify patients for surveillance?

Q2

What investigations for suspected MoM failure?

Q3

What are the risk factors for MoM disease?

Q4

What are the systemic effects of metal poisoning?

Q5

What are the surgical options for revision of a failed MoM hip arthroplasty?

Q6

What is the prognosis and what monitoring is required post-revision?

Key Learning Points

  • Metal ion threshold is 7ppb
  • Cup abduction >50° is a major risk factor
  • MARS MRI is the imaging of choice
  • Pseudotumour may be sterile or infected
  • Metal toxicity affects multiple organ systems
Quick Stats
Category
Arthroplasty
DifficultyIntermediate
Time Allowed6 min
Reading Time9 min
Investigation Types
bloodsimaging
Exam Tips

Read the clinical scenario carefully

Structure your answers systematically

Consider differential diagnoses

Justify your investigation choices

Think about management priorities