Implant Complications
A 58-year-old woman presents with persistent groin pain and clicking 4 years after a metal-on-metal hip resurfacing. She has no constitutional symptoms but reports that the clicking is audible. Examination shows a limp with reduced hip range of motion. Radiographs show a well-fixed femoral component but eccentric wear of the acetabular component. Blood cobalt level is 12 ppb (normal less than 1 ppb) and chromium is 8 ppb (normal less than 1 ppb). MRI with metal artifact reduction shows a large pseudotumor surrounding the hip. Regarding metal sensitivity and adverse reactions to metal debris (ARMD):
Mark each as TRUE or FALSE
Adverse reactions to metal debris (ARMD) encompass a spectrum including metallosis (tissue staining)...
Risk factors for ARMD include: metal-on-metal bearings, female sex, smaller component sizes (higher ...
ARMD only occurs with ceramic bearings; men are at higher risk; larger heads reduce edge loading; cu...
Diagnosis involves: blood metal ion levels (cobalt and chromium - elevation suggests wear), MRI with...
Treatment is revision arthroplasty with removal of metal-on-metal components and debridement of pseu...
Answer the questions to see explanations
Click T (True) or F (False) for each option