Metal-on-Metal Hip Problems with Cobalt Toxicity Lead to AAOS Warning

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Orthopedic surgeons are voicing concerns and raising awareness about potential problems with metal-on-metal hip replacements, which can lead to cobalt toxicity and other complications similar to those that resulted in a recent DePuy hip recall. 

On October 29, the American Academy of Orthopaedic Surgeons (AAOS) issued a press release with information for patients and the medical community about the potential risk for metal hip problems.

The AAOS warned that metal-on-metal hip implants, which are made of a cobalt-chromium alloy, can wear down and shed metal particles into the body, causing cobalt toxicity, a type of metal poisoning. They also warned that pain months after hip replacement surgery may be signs that of potential problems with a metal-on-metal hip replacement.

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A large number of recipients of metal hip implants have been found to suffer a complication, the AAOS said, many of whom require revision surgery to have the metal hip implant removed and replaced. The AAOS has launched a knee and hip implant registry at a limited number of hospitals to keep track of implant complications. AAOS officials hope the registry will be expanded into a national program after a pilot period at 15 hospitals.

In August, a DePuy ASR recall was issued for about 93,000 artificial hips after it was discovered that about 12% to 13% of the individuals who received the metal-on-metal hip implant had their device fail within five years.

Many individuals who received one of the defective hips are pursuing a DePuy hip lawsuit, alleging that doctors were expressing concerns to DePuy about a higher-than-expected failure rate for the metal hip system before the recall. The implants have been found to shed metal particles into the bloodstream, which could lead to cobalt toxicity.

Other metal-on-metal hip replacements have also been linked to similar problems. A number of manufacturers have their own version of a metal-on-metal hip, which may also cause an increased risk of hip replacement failure due to the release of metal particles.

In April, the United Kingdom’s medical agency indicated that they are reviewing concerns associated with metal-on-metal hip replacements, due to growing reports that they may cause non-cancerous tumors, swelling and other hip damage.

In addition to problems with the metal hip replacement, cobalt toxicity may potentially cause other serious health problems, including sight and hearing problems, cognitive impairment, hypothyroidism, neuropathy and rashes. In extreme cases it can lead to blindness, deafness, nerve damage and cardiovascular death.

Tags: DePuy, DePuy ASR, Depuy ASR Hip, Hip Implant, Hip Replacement, Knee Replacement, Metal-on-Metal Hip, Zimmer, Zimmer NexGen
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10 Comments

Anderson
I had both of my hips replaced one in 08 and the other in 09 with the belief that all my problems would be solved. The new hips are both the Zimmer Triology. I really thouth I could go on with my life as I am now only 48 years old. I now live in daily pain that has ended the lifestyle that I once led. Most of my day is spent in the bed or on the sofa as stitting has gotten to be imposible. I can walk for only short distances and then must lay down as sitting is not a option. This all started in 2008 when I had a pain in my left hip and was diognosed with AVN. In good faith I had the hip replaced as the surgen sugested. 6 months later I made the decission to have the right hip done as it also showed signs of the AVN and hip decay. I belived that given time and excercises sugested that all would be fine. During both of these replacements I continued to work my job and deal with the initial pain all the time expecting it to pass. Now my empoyer has closed down the company and I have no insurance to seek medical atention. I had to lay in a dirty county emergency room floor for 9 hours a few weeks ago to only get a injection for the severe pain and then sent into the street. I know that this is not a good hip implant as I have 2 and they are getting worse by the day. I will need to wait untill next year to get back in for MRI as the county takes months if you have lost your insurance. Please send your comments on the triology as it has destoyed my life and I can’t take the daily pain much longer. I als o have a mass in the groin area and have been told it may be from the replacement however I will need to wait until Sept 2012 for the county hospital as this is the next appointment for a surgery consultitaion. I feel like a total victim and I only find things on the Zimmer DuPuy and everything sounds exactly like this horible life changing experience.
Dan
In 2004 I had my left hip replaced. In 2007 I had my right hip replace in 2008 I started hearing and filling clicking and other sounds coming from my hips , I stared having pain in both groin and hip areas.I started having all kinds of medical problems.Shortness of breath, Headaches memory problems. Surgery in both eyes for cateracts and other eye problems (eye Dr. said I was too young for these kind of problem) I had to retire early from my job 62 yrs. old.I was hyersensitive to pain of any kind.I was diagnosied the type II dieabetis. My brain did not seem to be functioning like it should be.I had a blood test done 2011. I had cobalt and chromuim posining from my hips. Had revisions done may2011on right hip and sept.2011 on the left. many of the sytems are better. I had the Johnson & Jhonson DePuy MOM hips. They need to pay for this they knew about problems but did nothing.
rosa
my spose has had both hips replaced,in 2007 he had cardiomyopathy and he never felt like he could walk without a cane.now his levels of cobalt and chromium are 5.9 a d 43. he is 56yrs. he has diabetes and hbp.iam afraid that this toxcity will be the final straw that will lead to his death. all that is being done for him is monitoring of his toxcity levels.what kind of dr. should he be seeing?
carol
My first hip replacement (metal on metal by DuPuy) in 2006.This so far has not caused any problems. But 2010 I had the same part in second hip and within 4 months having unexplained pains in my feet,especially around the ankles. Then 10 months after surgery clicking and feeling of insecurity around the hip area. At this point visited the surgeon, had x-ray and blood tests. Cobalt level 51 Chrome 27 these are very high levels. I was told that further tests were needed and that it was expected to have high levels with metal replacements At what point is high too high!!.At no point have the hospital tried to recall me,it was only at this doctors appointment that I found out about the recall.Since this visit in January 2011 when I was told unless I sign a disclaim form I would not get a claim form!!! Next stop lawyer. This is the only way to deal with the surgeons and hospitals. They are supposed to be the ones to care for their patients, but don’t sign anything before seeking advise. I am in Southern Spain. There are many cases which are now coming to light, as much information as possible needs to be published to make sure that all people involved are aware.
Philip
I had metal on metal hip replacement in 2006. No problems since.
Rusty
In June 2005, I had hip replacement. I have not been out of pain since. Stanford says my hip is “trilogy” not “ASR”. Yet I have extreme night sweats, groin, hip & leg pain. Digestive problems, ringing in my ears and severe rashes that do not go away. My primary care giver is a FNP. Margaret Jacobs has been tireless in her pursuits for the causes and treatments whereas the surgeon just fluffed my pain and discomforts off. He did a “great surgery”, he was finished in his book. I understand DePuy did a recall for one of their hardware, but I wonder if other products should be in the same category.
Dennis
I took Zocor in March of 2006 after having 3 heart stents put in. I had severe nightmares and severe muscle pain and weakness to the point of not being able to close my hands or walk without help. I couldn’t work, my wife did all of the daily chores and milking. I was an active dairy farmer untill this happened. My wife called the Heart Dr. and told her what was going on and she said to stop taking Zocor immediately because some people get severe reactions to the drug. I was declared totally disabled by August ,the Drs. thought I had ALS. We had to sell the cows and all of the young stock because I was unable to work and farm anymore. There was no way my wife could do all that work by herself, even though she wanted to try and do it. I have been through hell, after 2 plus years the well known top ALS Dr. told me, that I don’t have ALS! That was a blessing to hear that! I know what caused all this it’s ZOCOR!!!
Trish
I had a metal on metal hip resurfacing in 2004. From day one, I knew something was wrong due to inflammation & pain in hip and buttock. Returned to my surgeon twice over the years – he diagnosed bursitis with no investigative testing. In the past year, I have had severe hand and foot pain, memory deficit, inability to walk any distance or carry. I had to leave my job. By chance last summer, I participated in a survey conducted by another surgeon – and they found tumours on my ultra-sound and elevated levels of cobalt ions in my blood. Subsquently – an MRI revealed nothing amiss. Had revision surgery in December of this year – and my surgeon was greatly surprised to find my tissues inflamed with metallosis, and the device knocking a hole in my posterior hip requiring a bone graft to correct. I have a long healing ahead of me. There is no law firm in Canada representing those of us ( and I know several persons) who are suffering from this metal poisoning. I have read articles describing this metal poisoning as far back as 1975 . A pre-op cobalt sensitivity test could have avoided all thispain and expensive revisions. I’ve also read these cobalt -chrominum devices were never tested before implantation in humans. Let the human guinea pigs rise up and sue these companies for the terrible pain and losses they are causing !! The metal on metal devices continue to be used with no testing for metal sensitivity and that is a crime.
JIM
REQUEST FROM YOU FAMILY PHYSICIAN TO RUN A HEAVY METAL PANEL ON YOU, ESPECIALLY COBALT AND CHROMIUM. YOU DEFINITELY HAVE THE SIGNS AND SYMPTOMS OF METALLOSIS. TAKE SOME ARTICLES DEALING WITH METALLOSIS TO YOUR GP. THEN IF AND WHEN THE TEST RESULTS COME IN, YOU WILL HAVE OBJECTIVE FINDINGS THAT CAN PROVE YOUR CASE TO THE ORTHO’S. IT IS SO SAID THAT THESE DOCTORS ARE QUICK TO JUDGE WHEN THEY HAVE PATIENTS WHO DO NOT HAVE A FAVORABLE OUTCOME. STEER AWAY FROM THESE TYPE PHYSICIANS. YOU WILL SEE AN AWARENESS COME OVER THEM BUT SOME WILL BE RESISTANT TO ACCEPT, WHEN THOUGH THEY HAVE NO FAULT IN THE DESIGN, MOST DOCTORS ARE FEARFUL OF LAWSUITS AND PRACTICE AS SUCH ELIMINATING RISK. START WITH THE BLOOD TEST, THEN CALL FOR PHYSICIANS WHO DO REVISION WORK. YOUR MAJOR UNIVERSITY HOSPITALS WILL HAVE THE EXPERTISE TO GIVE YOU RELIEF. THIS IS NOT IN YOUR HEAD UNTIL ALL MEASURES HAVE BEEN TAKEN TO RULE-OUT ANY HIP PATHOLOGY. TAKE THE INITIATIVE TO TAKE CHARGE OF YOUR OWN HEALTH, IF YOU DO NOT, THEN WHO ELSE WOULD DO IT? GOOD LUCK
Twanda
I had hip replacement July 2004. Since that time the surgeon that did the procedure, fired me from his practice because he did not have stones to talk humanely to me, and discover, that I was not, am not, guilty of things he thinks of me. Since the surgery, I have unexplained fevers, pain in the groin, leg, and hip areas. I have lost hearing, have had cataract surgery X2, but loss of sight as well. I have constant digestive problems, I have virtually no short term memory. I have gone to another surgeo,with my complaints, but he sluffed me off, because he termed me as “looking for attention”.

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