Adverse reaction to metal debris with accompanying gout and amyloid deposits in hip arthroplasty

Abstract

Adverse reaction to metal debris (ARMD) is a known complication of metal-on-metal hip arthroplasty. There has been one previously reported case of ARMD with concomitant gout in the setting of a hip arthroplasty. We report a case of ARMD with accompanying monosodium urate crystals as well as amyloid deposition in the hip of a patient who had undergone a metal-on-metal hip arthroplasty. This is the only published case to date of these 3 conditions co-existing, although it is possible that the incidence is higher since these require special diagnostic tests that are not routinely performed. It is postulated that these entities are biochemically associated with each other rather than being purely coincidental.

Keywords

• Adverse reaction to metal debris
• Adverse local tissue reaction
• Pseudotumor
• Metal-on-metal hip arthroplasty
• Gout
• Amyloid