Recalled prosthesis and metal on metal bearing
1. Introduction
Some patients may have a known recalled hip implant system or metal-on-metal (MoM) implants. These are unique and special considerations.
2. Indications for implant revision
Implant revision along with fixation stabilization of the periprosthetic fracture might be indicated.
3. Presurgical workup
MoM
- MRI to determine presence of pseudotumor, disruption of the hip abductor mechanism, unrecognized damage to other soft tissues including the neurovascular structures.
- Serum or whole blood samples for trace metal ion levels (cobalt and chromium)
- Preoperative hip aspiration to rule out infection
Suspected recalled implants
- Obtain record of index surgery
- Confirm the implants are recalled by checking the serial and lot numbers with the manufacturer
Note: The risk of continuous retention of these implants versus revision requires a detailed discussion with the patient and the family and agree on the treatment plan.
