The literature article entitled, "penetration of a metallic femoral head through the acetabular shell" written by robert a.
Sherman, md, and timothy a.
Damron, md published by the journal of arthroplasty vol.
24 no.
7 2009 accepted by publisher 3 september 2008 was reviewed.
The article purpose was to report on one case of an (b)(6) year old man who underwent l tha implanted with depuy profile stem and acetabular cup system.
Medical history includes coronary artery disease, hypertension, osteoarthritis, dysrhythmia and trigeminal neuralgias.
Eighteen years post implantation he presented painful hip rom and a shortened, externally rotated left lower extremity.
Radiographs revealed the appearance of a traditional dislocation but the head/neck was noted to be overlying the acetabular component on both anteroposterior and lateral views so no attempts at closed reduction.
Revision operation was performed and intraoperative findings included metallosis, eroded poly liner and eroded metal shell, osteolysis with supra-acetabular bone surrounded by blackened metal debris.
All components including stem were removed and replaced.
Cancellous allograft utilized in acetabulum and allograft struts utilized in femur in conjunction with cable plate and wiring.
It was estimated a 1300 ml blood loss.
Patient was placed in icu and within 12 hours his medical condition worsened necessitating re-intubation and immediately followed by catastrophic cardiac injury and died.
Depuy products utilized: profile stem, metal head, metal cup, poly liner.
Adverse events: death, cardiac failure, dislocation, revision, foreign body reaction (stemming from liner, cup and head as the liner was worn and cup and head resulted in metal debris with note of implant erosion), major bleed, pain.
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