Chromium and Cobalt Poisoning: What are the Long Term Side Effects of Metallosis?

It is likely that the recipients of a metal-on-metal hip implant have heard about the possible consequences from the metal shavings which can be released into the body when the metal cup and ball rub against one another during normal activities. Tiny ions of cobalt and chromium shear off when the two surfaces meet and those ions can lodge in the surrounding tissues or can end up in the bloodstream. As more and more metal hip implant patients are realizing the seriousness of metal toxicity, blood testing for elevated levels of metals is increasing. In many cases patients have been found to have levels of cobalt and chromium in their bloodstream which are as much as a hundred times normal levels. 

Although slightly elevated levels of these metals are fairly normal for patients with metal-on-metal hip implants, extreme elevations can be very dangerous—and anxiety-producing for the patient. DePuy released a report indicating that concentrations of the metals greater than 7 parts per billion are cause for concern. The Mayo Clinic has set somewhat different reference values, stating that blood serum concentrations of chromium greater than 1ng/mL suggests significant wear of the metal implant while serum concentrations greater than 5.0 ng/mL of cobalt can be considered toxic and also suggest significant wear of the prosthesis. Remember that 1 PPB (part per billion) equals 1.0 ng/mL.

A person with cobalt or chromium toxicity may actually experience no overt symptoms from their hip implant however the long-term damage can be significant. In addition to being used in metal hip implants cobalt is used in dental prostheses, pigments to color ceramics, magnets, platinum jewelry, petroleum, tires and in radiotherapy and certain industrial applications including radiation sterilization of medical supplies and foodstuffs. The naturally occurring mineral cobalt form is in Vitamin B6 and is an essential trace element with deficiencies leading to anemia. Cobalt which enters the body from a metal implant, however, is a much different story and can be extremely dangerous.

Typical symptoms of cobalt poisoning include stomach problems, nerve damage, thyroid or kidney problems, disorders of the skin, hemorrhages and cardiovascular risks. Chromium toxicity can result in DNA mutations, problems with the reproductive system, impaired liver functioning and a possibility of elevated cancer risk. Although chromium toxicity does not appear to result in cardiovascular problems the metal can cause serious disruptions in the reproductive system. Elevated cobalt levels could prevent the body from repairing DNA while elevated chromium levels can result in DNA mutation. Cobalt and chromium in excessive levels can cause severe inflammation in the tissues surrounding the hip implant and have also been known to adversely affect the respiratory system.

In fact, toxicity from cobalt and chromium can take months or years to manifest, and each person will experience the toxicity in a different manner. 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).” A blood test is necessary to measure the levels of the metals in the bloodstream and many surgeons consider any level of cobalt over 5.0 micrograms per liter of blood to be toxic and anything over 7.0 micrograms of chromium per liter of blood to be a risk to the patient’s health. Cobalt can be stored in the liver but not the bones and can remain in the red blood cells for three months.

It is crucial that any person who has a metal-on-metal hip implant have regular blood testing done and also that all persons who could potentially have toxic metal poisoning consult an experienced attorney who can provide the information necessary to make decisions which could affect the future. Sullo & Sullo attorneys are legal professionals who understand all the issues surrounding metal-on-metal hip implants and want only to assist you in determining whether you should join in the lawsuits against DePuy. It can be very frightening to feel as though your body has been invaded by toxic metals through no fault of your own. Sullo & Sullo attorneys offer compassion and a high level of expertise to guide you through the process and protect your future.