Kim Chul-Ho, Choi Young Hyun, Jeong Mi Yeon, Chang Jae Suk, Yoon Pil Whan
Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Hip Pelvis. 2016 Dec;28(4):259-263. doi: 10.5371/hp.2016.28.4.259. Epub 2016 Dec 28.
In 1960s, toxic heart failure due to cobalt poisoning was firstly reported from Canadian industrial worker. Following development of bearing materials in hip arthroplasties, using cobalt-chrome alloy in bearing surface, there were rarely reported of systemic affect toxic cobaltism include toxic heart failure due to articulation wear in Western countries. It could be happened more easily by third body wear from ceramic particle especially revision total hip replacement (THR) surgery using cobalt-chrome alloy following ceramic articulation breakage which index surgery performed by ceramic on ceramic bearing. In Korea, due to many surgeons prefer ceramic on ceramic bearing in THR compared to Western countries, it might be more important issue within a time. However in our knowledge, there was no previous report about cobalt poisoning heart failure in Korea. It is still very rare and hard to diagnose cobalt intoxication heart failure after THR, so we report a case of fatal heart failure caused by cobalt intoxication after revision THR in 53-year old man who successfully underwent re-revision THR.
20世纪60年代，加拿大产业工人首次报告了钴中毒导致的中毒性心力衰竭。随着髋关节置换术中轴承材料的发展，在轴承表面使用钴铬合金，西方国家很少有关于系统性影响的中毒性钴中毒的报道，包括由于关节磨损导致的中毒性心力衰竭。特别是在陶瓷关节破裂后使用钴铬合金进行翻修全髋关节置换术（THR）时，陶瓷颗粒的第三体磨损更容易发生这种情况，而初次手术是陶瓷对陶瓷轴承的THR。在韩国，与西方国家相比，由于许多外科医生在THR中更喜欢陶瓷对陶瓷轴承，这在一段时间内可能是一个更重要的问题。然而据我们所知，韩国此前没有关于钴中毒性心力衰竭的报道。THR后钴中毒性心力衰竭仍然非常罕见且难以诊断，因此我们报告一例53岁男性在翻修THR后因钴中毒导致的致命性心力衰竭病例，该患者成功接受了再次翻修THR。
