A Misdiagnosed Complication of a Metal-on-Metal Total Hip Arthroplasty.

Introduction: The enterobacterial genus includes a number of human pathogens. Large-diameter, metal-on-metal prostheses are no longer used because of their high failure rate. Here, we describe the first case of infection of a metal-on-metal total hip arthroplasty.

Clinical Examination: A metal-on-metal prosthesis failed ten years after implantation. After surgical revision, bacteriological testing revealed the presence of a pathogenic strain of . Combination antibiotic therapy resulted in a favorable clinical outcome.

Discussion: Three cases of hip arthroplasty infected with have been described in the literature. The present case is the first infection of a metal-on-metal total hip arthroplasty. We suggest that the risk of infection is increased by the release of metal wear particles and their influence on the surrounding tissue.

Conclusion: When a large-diameter, metal-on-metal total hip arthroplasty fails, the known complications associated with this type of prosthesis should not deter the physician from screening for an infectious process that requires specific treatment.