Blind and deaf after total hip replacement?

Symptomatic cobalt-chromium intoxication is extremely uncommon after total joint arthroplasty and evidence of it is only anecdotal.

This operation is regarded as one of the safest in the surgical field, millions of total joint replacements having been done worldwide over the past five decades.

Studies show little evidence of the presence of significant wear of the cobalt-chromium components of total hip replacements that use highly cross-linked polyethylenes in combination with metal.

We are puzzled as to where the cobalt-chromium was lost. The figures included are not conclusive in this respect. Was it lost on the femoral head or at the femoral neck region due to impingement on the (ceramic) socket? Was the loss due to the revision that took place in 2006 when a ceramic head was changed for a cobalt-chromium head, or could the placement of a cobalt-chromium head in combination with the previously inserted ceramic socket explain the loss of cobalt-chromium? After the resection arthroplasty, the patient’s vision “partially improved”, while “metal ion concentrations decreased but remained higher than reference values”.

These statements do not prove any clear relation to the operation.

We believe this Case Report generates more questions than answers and leaves physicians with unnecessary concerns about the safety of total hip replacement. Furthermore, we believe this patient was left with a disabling condition. Did the authors panic and become blind and deaf to the evidence of the superior wear characteristics of modern hip prostheses?

We declare that we have no conflicts of interest.