Cutaneous metallosis in patient with knee prosthesis composed of cobalt-chromium molybdenum alloy and titanium-aluminum-vanadium alloy

Titanium cutaneous metallosis after reverse total shoulder arthroplasty

“…In the other twelve published cases, the skin discoloration was similar to that observed in our case, bluish-grey to bluish-black [1,3,5,7,9,20,28,[31][32][33]37] and occurred after hip [1,7,9,33], knee [7,20,28,32,37], elbow [3], or, as in our case, shoulder [20,28] arthroplasty.…”

“…Skin discoloration is a rare manifestation of metallosis complicating joint arthroplasty. To our knowledge, only 12 publications have reported a total of 13 cases of this type of local cutaneous metallosis [1,[3][4][5]7,9,20,28,[31][32][33]37,[3][4][5][6][7][8][9][10][11][12][13]23].…”

Catastrophic metallosis after tumoral knee prosthesis failure: A case report

“…In that time a catastrophic soft tissues metal deposition occurred. As described in a previous paper by Callender et al [12], our patient presented a large area of cutaneous metallosis characterized by dyspigmentation of the skin overlying the joint space of the affected limb.…”

Systemic cobaltism manifesting as oral mucosal discoloration and metallic gustation after metal-on-metal hip resurfacing

“…Biopsy would be needed to confirm this theory. This ionic [4] or nanoparticulate [34] mechanism differs from that of local metallic staining, local tissue reactions, and spread of larger particulate debris to the overlying epidermis through lymphatic metastasis, which results from abrasion and causes tattooing rather than transient discoloration [2] , [3] , [6] , [7] , [8] , [9] .…”

“…Wear and corrosion may result in large particulate, nanoparticulate, and ionic metal debris that can metastasize locally through lymphatics or undergo phagocytosis and systemic transport via serum proteins or intracellularly in endosomes depending on its valence [3] , [4] , [5] . Particulate debris may manifest as local discoloration and adjacent epidermal tattooing, pseudotumor, and adverse local tissue reaction (ALTR) (metallosis) [2] , [3] , [6] , [7] , [8] , [9] , [10] . Systemic metal toxicity, notably systemic cobaltism, may potentiate organ failure and distant discoloration, seen once before as green tongue discoloration with vanadium toxicity from ceramic-on-ceramic components [5] , [11] , [12] , [13] .…”