Shocking- How Implant In Hip Led To A Heart Attack

New Delhi, 4 Sept 2019:

 

A man with a broken hip who had undergone multiple surgeries was diagnosed with an unusual complication at the AIIMS Trauma Centre recently.

 

The doctors found that the 37-year-old had suffered a serious damage to the heart muscles due to the increased toxicity after the use of a cobalt-chromium implant in a revision surgery.

 

The normal range of serum cobalt level in the body ranges between 0.03 microgram per litre and 0.29 microgram per litre. But in this case, the doctors found the level to be 373 micrograms per litre.

 

A case study on the patient which was published in ‘The Archives of Bone and Joint Surgery’ also revealed that the serum cobalt level continued to be very high despite the surgery done to remove all the accessible black soft tissues. “His cardiac function continued to deteriorate and he had to be admitted in the ICU. He died after three months’ of waiting for a heart transplant,” said Dr Rajesh Malhotra, chief, AIIMS Trauma Centre.

 

Malhotra explained that most hip implants in young patients have ceramic bearing surfaces because of their low cost compared with titanium implants. “But there is a risk of a fracture of the ceramic heads in rare circumstances,” he said.

 

The 37-year-old underwent the first surgery to fix the hip after an accident 16 years ago. The fracture healed, but he developed interruption in blood supply to the joint for which he underwent another surgery — total hip replacement — five years later using ceramic on ceramic articulation. Simply put, both the balls and the socket of the replaced joint were made of ceramic.

 

Five years later, the patient developed difficulty walking. When imaging tests were conducted, a fracture of the ceramic head was discovered. Then, the patient underwent the revision surgery to replace the fractured head with a cobalt and chromium one.

 

Three years later, he again developed pain in the joints along with breathing difficulty. “The hospital where he was operated upon for the revision surgery referred the case to us. We advised the patient to undergo another surgery immediately, but the family delayed it by around four months. By then, the toxicity had affected the heart severely,” Malhotra said.

 

He explained that such complications were rare. “People who have undergone revision surgery for a failed total hip replacement should not get scared after knowing about such complications. They should, however, be cautious of any symptoms that could signal toxicity in the body. It is advisable to undergo a routine follow up and blood tests for serum cobalt following the revision surgery,” he added. ET Healthworld