True Story – Patient With High Cobalt Levels
How Much Is Too Much Cobalt and Chromium Ions?
While both chromium and cobalt ion levels are raised in clients with MoM implants, cobalt is the most important factor to metal ion toxicity.6 When cobalt was used to treat refractory anemia in patients in the 1960s, symptoms of cobaltism were explained and consequently confirmed to consist of neurological, heart and endocrine symptoms.1,2.
Pathology labs are reporting an increasing number of individuals who have had an MoM THR and have really high serum cobalt concentration ()1000 nmo/L).7 Serum reference varies for cobalt and chromium are 0– 20 nmol/L and 0– 100 nmol/L, respectively.7 In individual case reports, patients with high serum cobalt concentrations who go through modification surgical treatment with ceramic– plastic revisions experience a fast fall in serum cobalt and considerable renovation in cardio and neurological function.8.
The vital link between symptoms and peak metal ion levels or the length of exposure to these ions continues to be vague. As a result there is an absence of consensus worldwide as to whether metal ions released from MoM implants might cause systemic problems in addition to those that could happen at the site of implantation, and more study is required to develop levels at which the presence of metal ions may cause toxicity.1 Many people with MoM THRs and high cobalt levels have totally operating athroplasties and no indicators or symptoms of toxicity. Neither the Australian Therapeutic Goods Administration nor the U.S. Food and Drug Administration has pointed out the concentration of heavy metal ions needed to produce unfavorable systemic occasions.
What is Cobalt and Chromium Ion Poisoning?
Combinations of cobalt and chromium is the most commonly used alloy in MoM hip implants. In a normal-functioning MoM hip implant, the cobalt and chromiun alloy allows for smooth motion of movement and greater weight bearing on the implant.
Cobalt and chromium ions are also released between the “cup-and -ball”, where the ball joint of the hip implant meets the hip socket. Patients can experience cobalt poisoning or chromium poisoning seperately, or in some cases both types can occur, with cobalt poisoning being the
most common. It is normal for the hip implant to shed minimal amounts of loose metal fragments, so it is advised that those with a MoM hip implant should take a cobalt and chromium ion blood test to monitor metal levels in the blood. However, repeated elevated levels of cobalt and chromium ions in the blood or surrounding tissue of the implant could very well indicate that a cobalt and chromium poisoning has occurred.