Chromium and Cobalt Toxicity and the DePuy Hip Implant

Posted By Craig McClellan || Jan 10, 2011

We've previously written about the recall of DePuy Hip Implants. What we haven't addressed is what to consider in deciding whether to replace the recalled DePuy Hip Implant. Some people that have the recalled hips in place are not experiencing much pain, or at least not enough to want to undergo another operation to replace it, along with all of the rehabilitation and recovery that would follow such an operation. DePuy calls this replacement surgery, which involves cutting out the defective hip and implanting another, a "revision." It sounds much less painful and disruptive to "revise" something, than to tear it all out and pound a replacement part in.

We've previously written about the recall of DePuy Hip Implants. What we haven't addressed is what to consider in deciding whether to replace the recalled DePuy Hip Implant. Some people that have the recalled hips in place are not experiencing much pain, or at least not enough to want to undergo another operation to replace it, along with all of the rehabilitation and recovery that would follow such an operation. DePuy calls this replacement surgery, which involves cutting out the defective hip and implanting another, a "revision." It sounds much less painful and disruptive to "revise" something, than to tear it all out and pound a replacement part in.

Patients who have a DePuy ASR Hips must consider the advice of their orthopedic surgeon as to whether it needs to be replaced. If pain, clicking or restrictions in movement are being experienced, the orthopedic surgeon will conduct tests to determine the functional ability of the hip and how intact it is. The tests will include physical manipulation by the doctor, but may also include x-rays, MRI's and bone scans. These tests will determine the placement of the ball into the socket, and whether parts have moved, are loose or whether there has been noticeable deterioration.

In addition to physical and imaging tests, doctors should have blood tests performed to measure the presence of chromium and cobalt in the blood. These two toxic, heavy metal components, can arise from the interaction of the cobalt ball with the metal socket in the defective DePuy Hips. Inadequate ball-in-cup clearance, and the shallow cup of the device, can cause fit, movement and deterioration problems. The deterioration occurs when the metal-on-metal contact of the ball and cup cause metal ions to flake off and invade the tissues and blood. This process can result in pseudo tumors, and dark or black staining of the tissues and fluids, as the cobalt and chromium from the DePuy Hip enter the bloodstream. Levels of these toxic metals have been reported at up to one hundred times normal in defective DePuy Hip implant patients.

The dangers of chromium and cobalt poisoning have not been extensively studied, perhaps because they are rare metals to find at toxic levels in the blood. However, it is known that signs and symptoms of cobalt poisoning can include visual impairment, hearing impairment, cognitive impairment, cardiomyopathy, peripheral neuropathy, hypothyroidism, and rashes. Anyone with a DePuy Hip implant should be suspicious if they experience any of these symptoms, and should immediately consult a physician.

Because of the dangers of cobalt and chromium poisoning, DePuy Hip implant patients need to be monitored over time, if their blood levels of these metals are not alarming when initially tested. The presence of elevated levels of these poisonous metals, even if not at toxic levels initially, creates a dilemma with respect to deciding whether to replace the hip. If the orthopedic surgeon determines that replacement is not necessary because of pain, looseness, or movement restriction, but blood levels of chromium and cobalt are elevated, he or she will recommend monitoring of the blood.

The patient will have to live with the knowledge, and perhaps anxiety, of knowing that their blood is carrying elevated levels of these metals, which could potentially be causing harm to other body functions. Over time, as that toxicity increases over time, so does the danger. And, so does the age of the hip patient. This means that potentially, by the time the chromium or cobalt reach toxic levels, the DePuy Hip implant patient will be older and less able to deal with the rigors of replacement surgery, rehabilitation and recovery.

If you have a DePuy Hip implant, you should consult your orthopedic surgeon to protect your health. You should also consult an attorney to protect your rights. The McClellan Law Firm represents DePuy Hip implant patients and provides consultation at no charge. If you have a DePuy Hip implant, contact us today.

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