Sunday, January 22, 2012

Cobalt and Chromium Blood Toxicity in Hip Replacement Patients

Chromium Poisoning and Cobalt Poisoning in the DePuy ASR hip replacement recall

DECEMBER 15, 2010 - HOUSTON — DePuy hip replacement recall by DePuy Orthopedics, Inc.’s metal-on-metal hip replacement system sent shockwaves through the international medical community. Given the fact that these devices have gained great popularity in recent years among orthopedic surgeons and patients alike, reports that the ASR XL Acetabular System and ASR Hip Resurfacing System were prone to early failure were met with great fear and unease.

Since the DePuy hip replacement recall, many of the 93,000 people worldwide who received an ASR hip implant have been scrambling to find answers to pressing health-related questions, especially as stories of blood toxicity, metallosis, chromium poisoning, cobalt poisoning, and other metal poisoning issues in patients have reached the public. And while countless studies have confirmed the consequences of metal wear debris from faulty orthopedics, many people are still left with grave concerns regarding the the DePuy hip replacement recall.

To date, the most widely researched side effect of DePuy’s defective hip replacement devices is the aforementionedmetallosis, which the Journal of Bone & Joint Surgery describes as “aseptic fibrosis, local necrosis or loosening of a device secondary to metallic corrosion and release of wear debris.” Design problems with the recalled DePuy ASR hip replacement system cause the metal components such as chromium and cobalt to rub against each other and shed microscopic metal particles into the body, which can result in soft tissue damage, inflammatory reactions and bone loss.

Of particular interest are the remarkably high concentrations of cobalt and chromium that have been found in patients with metal-on-metal hip resurfacings. In some cases, patients with recalled hip replacement implants have been found with 100 times the normal levels chromium and cobalt in their bodies.

The potential adverse effects of systemic cobalt and chromium ion elevation are the subject of ongoing investigation. While their individual implications on the body are somewhat understood, their combined effects are not. Doctors are struggling with patients’ questions because they simply do not have the answers. But based on existing research we do have some insight into the long-term ramifications of blood toxicity, chromium poisoning, cobalt poisoning and metallosis and sadly, it is not promising for DePuy patients.

Research Relating to the hip replacement recall – Metallosis, Chromium Poisoning & Cobalt Poisoning

As early as 2003, researchers at the Municipality of Vienna Gersth of Orthopedics Hospital in Austria found that patients with metal-on-metal total hip replacements had higher cobalt and chromium levels than those in a control group. Their findings, published in the Journal of Orthopedics Research, showed cobalt concentrations up to 50 times higher and chromium concentrations up to 100 times higher, and called for the careful monitoring of patients to ensure that any local or systemic complications are detected early on.

In 2006, a study published in the British Volume of the Journal of Bone and Joint Surgery found a correlation between metal ions from hip resurfacing and reduced T-cell counts. Researchers discovered that elevated cobalt and chromium levels in patients with metal-on-metal hip resurfacings were associated with statistically significant decreases in the level of CD8+ cells (T-cytotoxic/suppressor cells).

In the same publication in 2007, a review by researchers from University of Bristol in Bristol, UK, demonstrated the long-term effects of metal-on-metal arthroplasty. The team compiled data describing the release, dissemination, uptake, biological activity and potential toxicity of chromium and cobalt debris released from alloys currently used in modern orthopedics, which included a list of potential harmful effects on immunity, reproduction, kidney function, development, the nervous system and carcinogenisis.

Doctors from ANCA Medical Center in Ghent, Belgium, released a study in 2008 showing a direct correlation between inclination of the acetabular component and metal ion levels in hip implant patients. Their research found that there were significantly higher levels of metal ions in patients with steeply-inclined components, and that high concentrations of chromium and cobalt are toxic; are known to interfere with a number of biological functions; can result in fluid or mass formation with subsequent destruction of soft tissues; and can result in bone resorption leading to loosening of he implant or fracture of the femoral neck.

Finally, hip replacement patients with metal-on-metal implants have been shown to pass chromium and cobalt ions to their infants during pregnancy, according to research presented at the 2010 Annual Meeting of the American Academy of Orthopedics Surgeons (AAOS). Data showed that there is a correlation between whole blood metal ion levels in the mother and her infant at the time of delivery, which proves that the placenta is not a complete barrier to the transport of these harmful substances.

The known risks of failure of DePuy ASR hip implants are clear, and evidence of their dangerous, long-term health consequences is substantial. All patients should consult their physicians about regular monitoring in order to detect potential problems before it is too late. If you or someone you know received a defective DePuy ASR hip implant, you should also obtain the counsel of an experienced personal injury attorney. The DePuy hip is part of one of the biggest hip replacement recalls in history.

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Author: Andrew Sullo
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