Der Orthopäde
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Review Case Reports
[Chronic cobalt poisoning in endoprosthetic replacement].
This article outlines symptoms and therapeutic options in chronic cobalt poisoning including a case report in which metallosis caused by a ceramic-metal articular pairing led to almost complete loss of sight and hearing after revision of a total hip prosthesis. At primary revision the firmly incorporated stem was left in place. For a better offset only the head was exchanged from a ceramic to a metal model which articulated with a socket containing a ceramic inlay. ⋯ At the time of revision increasing concentrations of the alloy elements cobalt, chromium, and molybdenum were measured in the serum and liquor. The concentration of cobalt, in particular, was remarkably high. Treatment options in cases with chronic cobalt poisoning include chelation therapy with EDTA or BAL/DMPS.