CASI CLINICI   

Chirurgia 2015 April;28(2):95-9

Copyright © 2015 EDIZIONI MINERVA MEDICA

lingua: Italiano

Influenza dei livelli ematici degli ioni cromo e cobalto in paziente portatore di più artroprotesi: caso clinico e review della letteratura

Melis A. ¹, Piana A. ², Manunta A. ¹, Tranquilli Leali P. ¹

¹ Unità Operativa Complessa di Ortopedia e Traumatologia, Azienda Ospedaliera Universitaria di Sassari, Sassari, Italia; ² Istituto di Igiene, Azienda Ospedaliera Universitaria di Sassari, Sassari, Italia

Study on the evaluation of blood levels of cobalt and chromium ions in a male patient aged 75 with rheumatoid arthritis, with total knee arthroplasty on the left, hip prosthesis to the right, shoulder prosthesis to the left, with a recent episode of aseptic loosening hip to the right, with the values of the remote monitoring and assessment of possible complications and clinical outcomes. Over the past 7 years have been reported new cases of poisoning caused by corrosion of cobalt hip arthroplasty in cobalt-chromium alloy. To date, 29 cases were reported and all together by high concentrations of cobalt (up to 500 times higher than the Reference Values) and, in the case of release from implants, by massive metallosis in the tissues adjacent to the prosthesis. Its clinical features include ocular involvement with relative retinopathy and possible atrophy of the optic nerve, bilateral deafness, progressive decline in sensory, tremors, loss of coordination and memory, and also in 3 cases have been reported cardiac involvement. All symptoms, except for eye damage, improve and regress after removal of the source presentation. The recent reports of neurotoxic effects and the vast number of people potentially exposed have brought the matter to the attention of scientists determining the need to understand better the problem. This is also the target of our work, through the study of a clinical case, which has put us in front of an important choice about the type of surgical treatment and the assessment of the clinical status of the patient.