Elevated Titanium Levels After Revision Total Hip Caused by Previously Unreported Mechanism

Introduction: Metallosis from total hip arthroplasty is usually due to trunnionosis and is associated with elevated serum cobalt and chromium levels. Titanium levels usually remain normal. Methods: Here, we report two rare cases of elevated titanium levels, both with the same mechanism, which is a previously unreported cause of titanium metallosis. Results: In these cases, contact between cables and the titanium stem were the source. Discussion: Reports of isolated high titanium levels associated with total hip arthroplasty are rare. These cases illustrate a new mechanism from which this situation may arise.