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Letters Metal on metal hip implants

Arthroprosthetic cobaltism associated with metal on metal hip implants

BMJ 2012; 344 doi: (Published 17 January 2012) Cite this as: BMJ 2012;344:e430
  1. Stephen S Tower, orthopaedic surgeon1
  1. 1Anchorage Fracture and Orthopedic Clinic, 3831 Piper Street, Suite 220, Anchorage, AK 99508, USA
  1. stephentower{at}

Our initial experience with metal on metal hip implants1 was favourable. But several years later an uncharacteristically high proportion of patients developed progressive, unresolved, or new hip pain, some showing metal debris around the hip with tissue damage. Two patients had remarkably high cobalt concentrations, cognitive decline, cranial neuropathy, and early cardiomyopathy.2

We have just identified a fifth case of probable arthroprosthetic cobaltism …

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