Concerns now exist about the long-term biological effects of exposure to orthopaedic metal alloys, particularly serum cobalt and chromium ions derived from metal-on-metal wear debris in these patients. A pseudotumour mass complicating metal-on-metal resurfacing arthroplasty has been recognized by orthopaedic oncologists and specialist hip units. Pseudotumours may also present with a major nerve palsy. Two cases of femoral neuropathy due to pseudotumour masses caused by metal-on-metal resurfacing arthroplasty are presented. Preoperative neurophysiological studies showed severe and irreversible pathological changes to nerve function with neurohistopathological evidence of complete nerve destruction with a previously unreported pathological appearance. This may represent a previously unrecognized pathological process, possibly 'toxic' in nature, resulting from metal-on-metal wear debris. Prolonged follow-up and detailed clinical assessment of patients after hip resurfacing arthroplasty is advocated with planned and expeditious revision of any patient in whom evidence of femoral neuropathy develops.

Item Type:	Refereed Article
Keywords:	Femoral neuropathy; Metal-on-metal; Nerve destruction; Pseudotumour; Resurfacing arthroplasty
Research Division:	Medical and Health Sciences
Research Group:	Clinical Sciences
Research Field:	Orthopaedics
Objective Division:	Health
Objective Group:	Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:	Skeletal System and Disorders (incl. Arthritis)
Author:	Harvie, P (Dr Paul Harvie)
ID Code:	95333
Year Published:	2008
Web of Science® Times Cited:	31
Deposited By:	Medicine (Discipline)
Deposited On:	2014-09-30
Last Modified:	2014-09-30
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