This year’s international story of cobalt toxicity occurring from metal wear after total hip replacement surgery was first broken during a session at the ACR Winter Symposium on Jan. 29, 2014: A Diagnosis Out of the Blue by Robert D. Bunning, MD, FACP, FACR. Shortly after the symposium, in early February 2014, The New England Journal of Medicine1 and The Lancet2 published similar case studies within days of each other, and the story was picked up by CBS3 and The New York Times.4 To further add to the story’s acclaim, Juergen Schaefer, MD, one of the authors of The Lancet article, explained that the inspiration for the final diagnosis in his case was thanks to his recollection of a 2011 episode of House M.D.5 The episode starred Hugh Laurie as Dr. House and Candice Bergen as his ailing patient, who was diagnosed with heavy metal poisoning caused by her prosthetic hip.
Cobalt poisoning from hip prosthesis is rare but debilitating. It’s caused when the metal wears and introduces cobalt into the bloodstream. This is a known risk with metal-on-metal implants, but newer data are showing that it is also a risk with metal-on-polyethylene implants. According to Dr. Bunning, associate medical director at MedStar National Rehabilitation Hospital in Washington, D.C., it’s important for rheumatologists to recognize the symptoms of cobalt toxicity—including cardiomyopathy and thyroid issues—in patients who have prosthetic joints. Cobalt toxicity can lead to devastating effects, but if it is caught early enough and revision surgery is performed to remove the metal prosthetic, damage can be reversible.
I have recently had a second revision one right hip. I’ve had balateral hips for 33 years. For 18 before this most recent surgery 6 months ago ibegan experiencing life altering back pain. The revision revealed significant deterioration of the old implant. Now 6 1/2 months after surgery my body feels inflamed – IBP gives me relief. But this generalized feeling of inflammation is not improving ! I’m wondering if I have cobalt poisoning? I do not know who do see. My surgeon told me the prosthesis looks good and the pain is not from that. Should I see a rumatologist?
Get the blood work done to see if you have cobalt poisoning, ask your Primary doctor to do the blood work then you’ll know!! If you do have cobalt in your blood, you can get help.
You should see a Naturopathic Physican who specializes in testing and treating heavy metal toxcity. First an unprovoked urine test will be provided.
There is no treatment for treating heavy metal toxicity caused by an implant, other than to remove and replace the implant with a non metallic version.
There could be many things causing your back pain. Is the new replacement a metal on metal hip? Has your cobalt & chromium levels been tested?
I have elevated cobalt and a long list of issues, some very serious, yet the surgeon refuses to believe any of it could be caused by metal toxicity…Why would he? He has installed thousands of these crappy devices and doesn’t want to be liable!
So very true, surgeons don’t care they already got their money. They want to replace again so they can make more money. Piss on that, I will heal myself naturally!
I had hip repacement in 2012. Months after surgery, I developed contant fatigue and spells of mild dizziness. It was eventually discovered that I was allergic to cobalt. Replacement of the head of the hip occurrred. For the past six years I have dealth with fatigue, dizziness, and other nagging ailments. Needless to say, life has been a struggle. I hope the we can soon get some answers.
I am lucky to have a pro-active surgeon who has sent me for cobalt screening regularly since my hip replacement 7 years ago. As the levels rose dramatically,I was strongly advised to have the revision surgery .I reluctantly agreed to have surgery, despite the fact I had no pain.
I am now 10 days post-op, still having pain and swelling. Hoping for the best, but I had a knee replacement in same leg a year ago, and I can feel a lot of pain in that area, as well as my quads.
My doctor has me on mega vitamins, as well as pain management.