Neurology in metal-on-metal hip arthroplasty a case of suspected prosthetic hip-associated cobalt toxicity


Metal-on-Metal hip arthroplasty ; hip resurfacing ; cobalt intoxication ; cobaltism ; PHACT ; neurodegenerative disease ; Creutzfeldt-Jakob disease

Published online: May 29 2020

Jetse Jelsma, Henne Kleinveld, Annemieke Rozemuller, Ide Heyligers

From the Zuyderland Medisch Centrum, Sittard-Geleen & VUmc, Amsterdam


Metal-on-Metal hip arthroplasty was a frequently performed procedure, until concerns raised. Metal ion concentrations raise after the placement of a MoM prosthesis. This might lead to toxic concentrations of cobalt ions which might result in cardiotoxicity, thyroid toxicity and/or neuro-ocular toxicity. It is possible that raised cobalt and chromium concentrations have a role in the development of neurodegenerative diseases like Creutzfeldt-Jakob. We describe a patient with a MoM prosthesis who developed neurological symptoms were we thought of cobalt intoxication but turned out to be Creutzfeldt- Jakob disease.