Recalled prosthesis and metal on metal bearing

Some patients may have a known recalled hip implant system or metal-on-metal (MoM) implants. These are unique and special considerations.

Implant revision along with fixation stabilization of the periprosthetic fracture might be indicated.

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.