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Severe metallosis following oxidised zirconium wear in total hip arthroplasty
  1. Erato Gkouliopoulou1,
  2. Filon Agathangelidis1,
  3. Themistoklis Vampertzis2,
  4. Thomas Ntovas3
  1. 1General Hospital of Veria, Veria, Greece
  2. 2Orthopaedics Department, Agios Pavlos General Hospital of Thessaloniki, Thessaloniki, Greece
  3. 3Orthopadic Department, General Hospital of Veria, Veria, Greece
  1. Correspondence to Filon Agathangelidis, fagath{at}

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We present a case of a man aged 81 years who underwent a primary cementless total hip arthroplasty. Eight years after the index surgery, failure of the arthroplasty was revealed by the presence of the radiographic ‘cloud sign’ (figure 1). The original components used were the R3 acetabular cup with a Synergy femoral stem, highly crossed linked polyethylene liner and an oxidised zirconium (Oxinium) femoral head (Smith & Nephew Synergy, Memphis, Tennessee, USA). The initial investigation included a CT scan, full blood tests and …

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