Metallosis is a well-known complication of metal-on-metal total hip and knee arthroplasties. However, there are few reports of metallosis after arthroplasty of non-weight bearing joints. We report a case of severe metallosis that is considered to be caused by the mal-rotational alignment of the ulnar component after unlinked total elbow arthroplasty. When the joint was opened, we observed a black clay-like lesion that had expanded in the joint. Although mild deformity of the polyethylene insert was observed, there was no defect on the surface of the metal implant on macroscopic observation. Investigation of the removed prosthesis showed concentric sliding marks at the tapered working part between the humeral stem and condylar component indicating that metallosis was caused by abrasion at the junction. Surgeons should be aware of potential complications at the junction of the stem and condylar component when using a modular design.
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