Severe Metallosis Leading to Femoral Head Perforation

摘要

This article describes a case of severe metallosis in a 67-year-old woman who initially underwent primary total hip arthroplasty with a ceramic-on-ceramic articular bearing. This was subsequently revised to a metal-on-polyethylene articulation due to ceramic liner fracture. She presented with severe hip pain and a pelvic mass. Infective workup was negative. Perforation of the cobalt-chrome femoral head was observed intraopera-tively. In addition, signs of extensive metallosis, including embedded ceramic debris from the primary procedure, were observed. To the authors' knowledge, this is the first report of a ceramic fracture that led to cobalt-chrome femoral head perforation after subsequent revision total hip arthroplasty. The patient underwent successful revision surgery with a ceramic-on-ceramic coupling.