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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 4, 502-505.
doi: 10.1302/0301-620X.90B4.20302  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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Chromium, cobalt and titanium metallosis involving a Nottingham shoulder replacement

W. S. Khan, PhD, MRC, Clinical Research Fellow, Faculty of Life Sciences1; M. Agarwal, FRCS (Orth), Orthopaedic Specialist Registar2; A. A. Malik, MRCS, Orthopaedic Specialist Registar2; A. G. Cox, MPhil, Centre Manager3; J. Denton, MSc, Pathology Research Fellow1; and E. M. Holt, FRCS, Consultant Orthopaedic Surgeon2

1 Musculoskeletal Research Group, University of Manchester, Oxford Road, Manchester M13 9PT, UK.
2 Wythenshawe Hospital, South Manchester University Teaching Hospitals NHS Trust, Southmoor Road, Manchester M23 9LT, UK.
3 Centre of Analytical Sciences, Dainton Building, University of Sheffield, Western Bank, Sheffield S3 7HF, UK.

Correspondence should be sent to Dr W. S. Khan at The Old Bakery, Northaw, Hertfordshire EN6 4NW, UK; e-mail: wasimkhan{at}doctors.org.uk

Metallosis after shoulder replacement has not previously been described in the literature. We report a patient who developed extensive metallosis after implantation of an uncemented Nottingham shoulder replacement. He underwent a revision procedure.

Examination of the retrieved prosthesis showed that the titanium porous coating was separating from the humeral stem and becoming embedded in the ultra-high-molecular-weight polyethylene glenoid component, resulting in abrasive wear of the humeral component. There was metallosis despite exchange of the modular humeral head. Both components had to be exchanged to resolve the problem.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General