RT Journal
A1 Mikhael, Mark M.
A1 Hanssen, Arlen D.
A1 Sierra, Rafael J.
T1 Failure of Metal-on-Metal Total Hip Arthroplasty Mimicking Hip InfectionA Report of Two Cases
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2009
FD February 1
VO 91
IS 2
SP 443
OP 446
DO 10.2106/JBJS.H.00603
UL http://dx.doi.org/10.2106/JBJS.H.00603
AB 
New-generation metal-on-metal bearings made from cobalt-chromium alloys for use in total hip arthroplasty are now being utilized worldwide. A hypersensitivity reaction to a metal-on-metal bearing is a rare but reported complication and is thought to be a novel mode of failure of these implants1,2. These reactions were initially observed in patients with first-generation bearings and are now being reported in association with the second-generation metal-on-metal bearings currently in use3-5. Characteristic histological changes in the periprosthetic tissues obtained during revision surgical procedures in these patients have suggested the development of an immunological response2,6.