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.
Case Studies
Three different case studies of cobalt toxicity after hip replacement surgery were presented within 10 days of each other in early 2014. The remarkable nature of these case studies is that “hip pain was not a prominent feature,” Dr. Bunning says. The patients did present with similar symptoms, and all were found to have excessively high serum cobalt levels. Two of the cases involved metal-on-polyethylene implants, and one involved a metal-on-metal implant. The diagnoses of cobalt poisoning and subsequent revision surgery occurred in varying degrees of time for each patient, which led to differing outcomes.
Ann Heald says
December 16, 2018 at 11:46 pmI 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?
SeL says
March 27, 2019 at 8:33 pmGet 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.
Katie says
February 11, 2019 at 9:16 amYou should see a Naturopathic Physican who specializes in testing and treating heavy metal toxcity. First an unprovoked urine test will be provided.
Manny says
February 23, 2019 at 12:26 pmThere 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!
SeL says
March 27, 2019 at 8:36 pmSo 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!
David V. Hedin says
May 9, 2019 at 9:36 pmI 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.