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The treatment of femoral neuropathy due to pseudotumour caused by metal-on-metal resurfacing arthroplasty


Harvie, P and Giele, H and Fang, C and Ansorge, O and Ostelere, S and Gibbons, M and Whitwell, D, The treatment of femoral neuropathy due to pseudotumour caused by metal-on-metal resurfacing arthroplasty, Hip International: The Journal of Clinical and Experimental Research on Hip Pathology and Therapy, 18, (4) pp. 313-320. ISSN 1120-7000 (2008) [Refereed Article]

DOI: doi:10.5301/HIP.2008.2784


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 Details

Item Type:Refereed Article
Keywords:Femoral neuropathy; Metal-on-metal; Nerve destruction; Pseudotumour; Resurfacing arthroplasty
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Orthopaedics
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Harvie, P (Dr Paul Harvie)
ID Code:95333
Year Published:2008
Web of Science® Times Cited:31
Deposited By:Medicine
Deposited On:2014-09-30
Last Modified:2014-09-30

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