A Painful Metal-on-Metal Total Hip Arthroplasty : A Diagnostic Dilemma |
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Authors: | Thomas J. Blumenfeld William L. Bargar Pat A. Campbell |
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Affiliation: | ? University of California at Davis, Sutter General Hospital, Sacramento, California;† J. Vernon Luck Snr Research Center at Orthopaedic Hospital, University of California at Los Angeles and Orthopaedic Hospital Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California |
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Abstract: | Infection, loosening, osteolysis, or other causes can lead to the development of pain about a previously well-functioning total hip arthroplasty. An inflammatory reaction unique to metal on metal arthroplasty can lead to a painful total hip. A synovial biopsy is needed to make this specific diagnosis, and included in the differential diagnosis is infection. The workup of infection includes obtaining a C-reactive protein and erythrocyte sedimentation rate. Elevations of both the C-reactive protein and erythrocyte sedimentation rate are felt to indicate possible infection. This case report describes both of these findings and the treatment rendered in a painful subluxing metal-on-metal total hip arthroplasty presenting with ongoing pain and a large effusion. |
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Keywords: | painful total hip metal on metal metal hypersensitivity subluxation infection |
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