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全髋关节翻修术后因术中陶瓷骨折导致铬钴中毒并伴有严重全身并发症

Chromium-Cobalt Intoxication with Intense Systemic Complications following Total Hip Revision after Per-Operative Ceramic Fracture.

作者信息

Lecoanet Paul, Blangis Mathias, Garcia Matthieu, Legallois Yohan, Fabre Thierry

机构信息

CHU de Bordeaux, Place Amélie Raba-Léon, 33000 Bordeaux, France.

出版信息

Case Rep Orthop. 2019 Jan 27;2019:4209796. doi: 10.1155/2019/4209796. eCollection 2019.

DOI:10.1155/2019/4209796
PMID:30809405
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6369479/
Abstract

INTRODUCTION

Heavy metal intoxication after arthroplasty is extremely rare but could be lethal. We report the case of a 69-year-old woman, who presented intense systemic symptoms of chromium-cobalt intoxication after revision of per-operative fractured ceramic components with metal-on-polyethylene. Systemic toxicity occurred a year after surgery and expressed brutally with mostly central neurological symptoms. Chelation associated with revision surgery allowed rapid regression of all symptoms.

CONCLUSION

Revision of fractured ceramic, even per-operatively, should not be done with metal-on-polyethylene components, in order to avoid potentially lethal metal intoxication.

摘要

引言

关节置换术后重金属中毒极为罕见，但可能致命。我们报告了一例69岁女性病例，该患者在使用金属对聚乙烯的人工关节翻修术中，因术中陶瓷部件骨折而出现严重的铬钴中毒全身症状。全身中毒发生在手术后一年，并以主要的中枢神经症状突然表现出来。螯合疗法联合翻修手术使所有症状迅速缓解。

结论

为避免潜在的致命金属中毒，即使是在术中，也不应使用金属对聚乙烯部件对骨折陶瓷进行翻修。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6afd/6369479/4de195de4c08/CRIOR2019-4209796.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6afd/6369479/00910c3f54e1/CRIOR2019-4209796.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6afd/6369479/97ecde2d7e0b/CRIOR2019-4209796.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6afd/6369479/31cdd56e4784/CRIOR2019-4209796.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6afd/6369479/960bfe5aa8d0/CRIOR2019-4209796.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6afd/6369479/4de195de4c08/CRIOR2019-4209796.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6afd/6369479/00910c3f54e1/CRIOR2019-4209796.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6afd/6369479/97ecde2d7e0b/CRIOR2019-4209796.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6afd/6369479/31cdd56e4784/CRIOR2019-4209796.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6afd/6369479/960bfe5aa8d0/CRIOR2019-4209796.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6afd/6369479/4de195de4c08/CRIOR2019-4209796.005.jpg

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Case Rep Orthop. 2017;2017:9123684. doi: 10.1155/2017/9123684. Epub 2017 Aug 27.
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钴和铬诱导的神经退行性疾病中机制数据和生物标志物水平的最新综述
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Prosthetic hip-associated cobalt toxicity: a systematic review of case series and case reports.人工髋关节相关钴中毒：病例系列和病例报告的系统评价
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Current understanding of hexavalent chromium [Cr(VI)] neurotoxicity and new perspectives.六价铬[Cr(VI)]神经毒性的现有认识和新视角。
Environ Int. 2022 Jan;158:106877. doi: 10.1016/j.envint.2021.106877. Epub 2021 Sep 20.
陶瓷髋臼部件骨折翻修为金属对聚乙烯全髋关节置换术后的钴中毒
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4
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