Volume 1, Issue 4, Pages 99-102 (December 2015) Cardiac cobaltism: a rare complication after bilateral metal-on-metal total hip arthroplasty  John R. Martin, MD, Luke Spencer-Gardner, MD, Christopher L. Camp, MD, John M. Stulak, MD, Rafael J. Sierra, MD  Arthroplasty Today  Volume 1, Issue 4, Pages 99-102 (December 2015) DOI: 10.1016/j.artd.2015.10.002 Copyright © 2015 The Authors Terms and Conditions

Figure 1 Preoperative revision anteroposterior pelvis radiograph. Arthroplasty Today 2015 1, 99-102DOI: (10.1016/j.artd.2015.10.002) Copyright © 2015 The Authors Terms and Conditions

Figure 2 Intraoperative photo demonstrating placement of a ceramic femoral head with a titanium sleeve. Arthroplasty Today 2015 1, 99-102DOI: (10.1016/j.artd.2015.10.002) Copyright © 2015 The Authors Terms and Conditions

Figure 3 Intraoperative photograph showing dark staining of the surrounding soft tissue around the acetabulum consistent with metallosis. Arthroplasty Today 2015 1, 99-102DOI: (10.1016/j.artd.2015.10.002) Copyright © 2015 The Authors Terms and Conditions

Figure 4 The dark-stained tissue was consistent with severe metallosis and pseudotumor tissue after debridement. Arthroplasty Today 2015 1, 99-102DOI: (10.1016/j.artd.2015.10.002) Copyright © 2015 The Authors Terms and Conditions

Figure 5 Postoperative anteroposterior pelvis radiograph. Arthroplasty Today 2015 1, 99-102DOI: (10.1016/j.artd.2015.10.002) Copyright © 2015 The Authors Terms and Conditions

Figure 6 An electron microscopy of the cardiac biopsy that shows increased lipofuscin and vacuolar spaces consistent with cardiac cobalt toxicity. Arthroplasty Today 2015 1, 99-102DOI: (10.1016/j.artd.2015.10.002) Copyright © 2015 The Authors Terms and Conditions