Arthroplasty Today (Dec 2018)

Systemic cobaltism manifesting as oral mucosal discoloration and metallic gustation after metal-on-metal hip resurfacing

  • Joshua A. Shapiro, MD,
  • Scott M. Eskildsen, MD,
  • Daniel J. Del Gaizo, MD

Journal volume & issue
Vol. 4, no. 4
pp. 436 – 440

Abstract

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Systemic cobaltism is a debilitating complication of metal-on-metal (MoM) arthroplasty. In this report, we review a case of a 54-year-old female with metallosis from a MoM hip resurfacing and varying degrees of black discoloration of her tongue and metallic gustation as a result of systemic cobaltism. After explanting the metal components, thorough debridement, and conversion to ceramic-on-polyethylene arthroplasty, the patient’s oral mucosal discoloration and metallic gustation resolved. This represents the first documentation of systemic cobaltism from MoM hip resurfacing manifesting as oral mucosal discoloration and metallic gustation with resolution after explant, debridement, and conversion to ceramic-on-polyethylene total hip arthroplasty. Keywords: Metallosis, Metal on metal, Hip resurfacing, Systemic cobaltism, Tongue discoloration