February 18, 2015 - Potential blood toxicity from metal-on-metal hips requires vigilant monitoring. Those with a metal-on-metal implant should have the following medical tests performed:
· A yearly assessment to determine levels of pain, any decreases in joint function or any losses in vision or hearing.
· A yearly assessment which tests for levels of serum cobalt and chromium concentrations, and for those with elevated levels of metals, every three months thereafter.
· Physicians must be hyper-vigilant with patients who have poor renal function when testing for cobalt levels.
· Physicians must look at the patient as a whole, considering individual risks and stated symptoms when determining the effects of cobalt and chromium toxicity.
· Annual workups for asymptomatic patients should be performed.
· Among patients with high metal ion levels, physicians must determine whether there are other reasons to explain high cobalt readings such as occupational exposure, renal insufficiency, inappropriate use of dietary supplements or a second metal implant in the body.
Patients should also undergo regular x-rays and MRI tests in order to determine whether the hip implant shows signs of failure. Even those patients with no overt symptoms should have regular medical workups done to determine whether their hip implant is stable and whether there are any signs of metal toxicity or metal poisoning.