Cobalt-chromium toxicity following revision of total hip replacement

Abstract

Systemic cobalt-chromium (Co-Cr) toxicity following a total hip replacement is a rare complication that may sometimes lead to fatal consequences. We report a case of a 64-year-old woman, who presented with Co-Cr toxicity after revision of fractured ceramic components with metal-on-polyethylene. Systemic toxicity occurred a year after surgery and was expressed brutally with mostly central neurological symptoms. Revision surgery allowed rapid regression of all symptoms. Prosthetic revision with a metal bearing surface after a history of fracture of the ceramic bearing component should be avoided. Orthopedic surgeons and the different medical actors should be aware of this rare but serious complication to allow earlier management. Above all, multidisciplinary management is primordial to allow correct diagnosis and appropriate treatment.