Catastrophic failure due to aggressive metallosis 4 years after hip resurfacing in a woman in her forties—a case report

In March 2005, a 42-year-old healthy woman underwent a hip resurfacing procedure with a Birmingham metal-on-metal hip resurfacing implant (Smith and Nephew Orthopaedics, Warwick, United Kingdom) because of osteoarthritis secondary to mild hip dysplasia. After 4 years, she reported the onset of mild discomfort and instability in her hip and 6 months later she was referred to our unit because of radiographically visible aggressive periprosthetic osteolysis (Figure 1) and progressive pain. ESR and CRP were normal. The BHR implant is made of cobalt and chromium, and the levels of these metals in the blood were grossly elevated (Table).