By Mr. Vosinakis Ioannis, Orthopaedic Surgeon, Scientific Head of the Orthopaedic Department of ANASSA Clinic.
In November 2020, after much study of the literature and careful writing, the publication of a very interesting case at ANASSA Clinic, in the international orthopaedic journal Acta Scientific Orthopaedics, was achieved.
In February 2018, I was asked to examine an 80-year-old patient admitted to the clinic with severe neurological symptoms and pain in the right hip, in which he had undergone a total hip replacement five years ago. With the assistance of the neurologist, Ms. Bahlava, no apparent cause for the patient’s neurological picture was found. From the relatives there was information that his right hip had been troubling him with pain and metallic noise for 2.5 years.
Clinical examination revealed pain, bouncing and metallic sound during hip movements, while X-rays showed complete destruction of the prosthesis of the coxae. Both the polyethylene (plastic) and the metal shell had been corroded by the hard metal head. Neurotoxicity from the heavy metals released into the patient’s body was immediately suspected.
Laboratory tests at a specialized laboratory showed levels of cobalt and titanium in the blood 6-8 times higher than the permissible levels and in the urine 12-15 times higher. Quantities of these metals were also found in the cerebrospinal fluid, where they should not be detected. The arthroplasty was immediately revised with a change of the cotyledon and head. The removal of heavy metals from the body was done gradually, as there is no drug or other treatment for this condition. The patient’s neurological condition improved slowly and without full recovery.
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