Sullo & Sullo - Product Defect Blog

What are the Long Term Side Effects of Chromium and Cobalt in the Bloodstream?

Jul 29

Sunday, July 29, 2012  RssIcon

Patients who have undergone a metal-on-metal hip implant may be very concerned about the fairly recent reports of adverse health effects due to metal ion shavings which migrate into the surrounding hip tissue and bloodstream in some patients. The design of the metal-on-metal acetabular cup and ball make it likely that during physical activities the two parts will rub against one another, causing tiny particles of chromium and cobalt to shear off and enter other parts of the body. As more patients receive the crucial information they require, blood testing for elevated levels of these metals is becoming more common. In the case of the ASR implant, patient after patient has turned up with cobalt and chromium levels well over a hundred times normal levels.

Symptoms of cobalt poisoning can include neurological damages, irregularities of the heart and even seizures. While this is alarming enough, chromium comes with its own set of adverse health effects. While elevated levels of chromium do not appear to result in heart problems, they can wreak havoc with the reproductive system. Elevated cobalt levels can result in the inability of the body to repair DNA while elevated chromium levels can have the same effect and can also be responsible for the mutation of DNA. Both metals can cause hypersensitivity and inflammation in the tissue surrounding the implant, and chromium is known to impair liver functions. The respiratory system can be adversely affected by both chromium and cobalt, resulting in asthma and shortness of breath. An excess of either metal can lead to vision and hearing impairments and while there is no definitive data on the subject, many health experts believe that an excessive amount of either metal in the bloodstream can lead to cancer.

Both chromium and cobalt poisoning are extremely serious yet there is no way to confirm without a blood test to measure the levels of the metals in the bloodstream. Some orthopedic surgeons consider cobalt at any level over 0.3 micrograms of cobalt per liter of blood “abnormal,” and anything over 5 toxic. Other surgeons have chosen to only monitor those patients with levels of cobalt above that level of 5 micrograms of cobalt per liter of blood while others counsel patients with levels over 7 to undergo revision surgery with an implant which does not contain cobalt. Normal chromium levels range from 0.06 to 0.93 in healthy patients and the highest safe level in the bloodstream is considered to be 17 micrograms per liter of blood.

Cobalt is not an accumulating metal, meaning it is stored in the liver and processed out of the body through urine but not stored in the bones. The red blood cells which carry cobalt are thought to have a lifespan of ninety days, so in theory when the cobalt source is removed from the body the cobalt levels should return to normal. If the cobalt has caused the body’s inflammatory process to kick it, more serious ailments may have begun. Excess chromium can also be retained in the body’s tissues, and depending on the overall health of the patient may have a very difficult time processing the metal ions through the body’s normal elimination process particularly if the kidneys have been damaged by the excess metals.

Oddly enough, some patients who have extremely elevated levels of either metal could still not be medically diagnosed with metal poisoning. Some people will go into their doctor’s office feeling perfectly fine, have a blood metals test done and find they have a total of 20 parts per billion of these dangerous metals in their bloodstream. Once the surgeon brings the patient in for revision surgery they may open them up to find the tissues surrounding the implant are grey-brown in color signifying dead tissue. Other people could be experiencing chronic and significant levels of pain yet find their metal levels are well within the acceptable levels. It’s important to remember that a lack of pain or other symptoms does not mean you are not having problems from the metal-on-metal hip implant merely that some bodies are more tolerant to metal poisoning than others. Andrew Sullo, Class Action Lead Counsel & Managing Partner of Sullo & Sullo, LLP notes that “I have noticed that some clients complain of extreme pain but their metal levels are on the low end of the spectrum (1-2 parts per billion of chromium and cobalt). By the same token, I have seen some clients with little to no pain from the hip with cobalt and chromium which are much more elevated (in the 20-30 parts per billion range).”

While getting your blood tested is crucial, no matter your numbers it’s important to speak to a legal professional who can give you the information you need for your health and your future. The Sullo & Sullo attorneys are professionals who have a solid background in the metal-on-metal hip litigation and all that entails. They understand how frightening the thought of having your body invaded and poisoned with metal shavings from a hip implant you believed to be perfectly safe can be and are standing by to offer compassion and the highest quality of legal assistance. 


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