These elevated levels of serum cobalt and chromium are for real, so if you’ve had a joint replacement, getting them checked may be a good idea. DISCUSSION. If you have an allergy, imagine carrying that around in your knee. The biggest culprit for toxicity seems to be cobalt-chrome but there is no generally accepted threshold beyond which serum or blood concentrations of cobalt and chromium are known to be toxic8. Is this possible, and could it be a cause of pain or irritation after surgery? Patients suffering from the symptoms of metal hypersensitive demonstrate higher than normal levels of Cobalt in their bloodstream. In this curious study, the doctors “selected patients with a pre-operative known sensitisation to chromium, cobalt, nickel, or a cement component for a post-operative allergic reaction. ... Metal Attune knee components are made from a Cobalt-Chromium-Molybdenum alloy. They note: If you are looking to avoid knee surgery, see our main page Prolotherapy for knee pain for an alternative to surgery. Cobalt Chromium Metal Poisoning from Hip Replacements. Metal implants are used in a variety of orthopedic surgical settings, including fracture repair and joint replacement surgery. 1 Laitinen M, Nieminen J, Reito A, et al. Take the Quiz! Are you a chronic pain expert? Cobalt chromium poisoning is a risk for anyone with a metal on metal (MoM) hip replacement. In addition to Cobalt leaching into the bloodstream, thousands of DePuy knee replacement patients have suffered the device deboning at the point where the tibia is inserted into the device's sleeve. Doctors in Finland have released a new troubling study on the release of metal debris from knee replacement hardware. According to Healthline’s analysis of … Health Problems from Metal Ions: Metal-on-metal hips have raised other concerns, including potential harm from cobalt and chromium ions released into the bloodstream. My surgeon assured me at least 20 years. Background: Oxidized zirconium (Oxinium) was introduced as an alternative bearing surface to cobalt-chromium (CoCr) in an attempt to reduce polyethylene wear and decrease aseptic mechanical failure of total knee replacements. | 1/28/2019, Orthopedic Surgeons Recommend Knee Replacements When a Little Exercise May Be All That is Needed | 1/22/2019, Artificial Knee Manufacturers Battle With Patient Knee Infections | 1/17/2019, Knee Replacement Infections May Necessitate Amputation | 1/14/2019, Overweight Knee Replacement Candidates Should Consider Other Options | 1/9/2019, The DePuy Revision Knee Can Come Unglued Just as Easily as the Original Device | 1/7/2019, DePuy Knee Replacement Can Be Complicated by Osteoporosis | 1/3/2019, Knee Replacement Patient Should Lower Their Expectations | 12/18/2018, Medical Device Sales Representatives Are Present In Knee Replacement Operating Rooms | 12/13/2018, Knee Pain Patients Are Urged To Investigate Stem Cell Therapy Before Agreeing To Knee Replacement Surgery | 12/10/2018, The Risk of Infection May Outweigh the Benefits of the DePuy Knee Replacement Device | 11/29/2018, The FDA Failed to Adequately Test The DePuy Knee Replacement Device | 11/26/2018, DePuy Knee Patients Should Know When Enough is Enough | 11/9/2018, Senior Citizens Should Seek a Second Opinion for a Doctors Knee Replacement Advice | 11/2/2018, Senior Citizens With Osteoporosis May Want To Avoid Knee Replacement | 10/30/2018, DePuy Synthes Addressed the Failed DePuy Knee Due to Infections | 10/29/2018, Knee Replacement Market Estimated to Reach $10 billion Annually by 2024 | 10/24/2018, DePuy Targets Older Senior Citizens With The Revision Knee | 10/18/2018, Failed Knee Replacements Can Lead to Leg Amputation | 10/12/2018, Arthritis Knee Pain and Total Knee Replacement Surgery | 10/10/2018, Debonding, Infections, and Metal Hyper-Sensitivity Can Require DePuy Knee Replacement Revision Surgery | 10/1/2018, DePuy Blames Glue For Knee Replacement Device Failures | 9/28/2018, Arthritis Sufferers Should Think Twice Before Jumping Into Knee Replacement | 9/27/2018, The Meager Benefits of the DePuy Revision Knee Replacement Device | 9/25/2018, Lawsuit Alleged DePuy Failed to Recall the Knee Replacement Device | 9/22/2018, Alternatives to Knee Replacement Surgery for Senior Citizens | 9/19/2018, Blood Test Results May Be An Early Warning That An Artificial Knee Is About To Fail | 9/17/2018, The New DePuy Revision Knee Replacement System | 9/13/2018, Doctors May Be Overselling The Benefits of Knee Replacement Surgery | 9/10/2018, Total Knee Replacement Questions and Answers | 8/31/2018, Medical Device Studies Are Looking More Like Infomercials | 8/27/2018, Metal Hypersensitivity Can Cause DePuy Knee Failure | 8/24/2018, DePuy Knee Replacement System is sold primarily to senior citizens in spite of the product's age warning | 8/17/2018, Tibial Fractures and Loosening Cause DePuy Knee Failure | 8/15/2018, Report DePuy Knee Replacement Malfunctions Using The FDA's MAUDE System | 8/8/2018, A Physically Active Generation Demands More Knee Replacement Surgeries | 8/6/2018, Senior Citizens Will Require More From The DePuy Knee Replacement Device Than Merely Playing With The Grandkids | 8/2/2018, Setting the DePuy Revision Knee Terminology Straight | 7/30/2018, Senior Citizens Are Urged To Put Off DePuy Knee Surgery Unless Absolutely Necessary Here is a list of the different knee replacement implant materials and their pros and cons. Infection can occur years after knee replacement surgery, when bacteria enter the bloodstream and infect the surgical site, according to MayoClinic.com 1. Knee replacement surgery is the last option available to people suffering from debilitating osteoarthritis and painful knee injuries. 22 patients with total knee arthroplasty and metal-on-metal hinge connecting mechanisms were studied for whole-blood chromium and cobalt levels at 6 months, 1 year, and at 2 years or less after surgery. ELEVATED BLOOD COBALT LEVELS IN A PATIENT WITH BILATERAL METAL-ON-METAL HIP PROSTHESES . Infections are rare after knee replacement surgery, but they can occur. Fast forward to age 59. Monday, August 13, 2018 - Cobalt poisoning could result from metal to metal or metal to plastic friction in the DePuy Knee Replacement System. Another Attune knee problem is the device fails earlier than expected. The DePuy knee is made from a combination of metal and plastic parts including a Cobalt-Chromium-Molybdenum alloy. DePuy Attune knee replacement patients report tibial loosening. Another complication that is causing DePuy knee patient's enough pain and suffering to require revision surgery is having a hypersensitivity to the Cobalt core of the DePuy knee. cobalt and chromium) from the metal implant or from the metal particles will enter the bloodstream. Because it turns out that anyone who submits to joint-replacement surgery is at risk for developing a condition called arthroplasty cobalt encephalopathy, or ACE, but they may not know it — because the symptoms mimic those of Parkinson’s and even dementia! However, one problem that can happen with plastic implants is an immune reaction triggered by tiny particles that wear away from the spacer. If you or a loved suffered from DePuy knee problems including instability, pain, bone damage, and the need for revision surgery due to a defective DePuy knee, you may be entitled to damages. All patients who received revision surgery because of a potential allergic reaction were followed up post revision surgery.”, November 3, 2016: (National Institute of Health) Seven substances added to 14th Report on Carcinogens. The pragmatic approach adopted by most contact dermatologists for patients known to be allergic to nickel, cobalt or chromium and who require joint replacement is to recommend prostheses made of titanium-based alloys. Cobalt is used throughout the industrial world because of its extreme hardness. When a person walks with the DePuy knee they are experiencing the metal-on-metal contact of the Cobalt-Chromium alloy. Monday, August 13, 2018 - Cobalt poisoning could result from metal to metal or metal to plastic friction in the DePuy Knee Replacement System. Cobalt is a naturally occurring element used to make metal alloys and other metal compounds, such as military and industrial equipment, and rechargeable batteries. Although the percentage of patients having allergic reactions related to the use of cobalt-chromium alloys to is very low, one area of concern is the issue of tiny particles (metal ions) that may be released into the body as a result of joint movement. While tibial loosening causes wobbliness, pain, instability, and a decreased range of motion, metal hypersensitivity results in migraine headaches, body aches, nausea, infection and auto-immune disorders and severe psychological complications. We report two Australian patients with possible cobalt toxicity related to metal-on-metal total hip replacements. For years the focus following hip replacement surgeries has been on the physical condition of the hip itself. When should I involve a Prolotherapist in my care? Within months, she faced effects ranging from memory loss and visual disturbances to severe tinnitus and PTSD-like rage/anxiety attacks. Dermatitis on the knee following knee replacement: a minority of cases show contact allergy to chromate, cobalt or nickel but a causal association is unproven. Potential allergens were strictly avoided in the replaced prosthesis. Metal on metal contact of the DePuy knee can cause metal Cobalt shavings that are quickly absorbed into the bloodstream. Material fundamentals of titanium and cobalt–chromium alloys used in hip and knee replacement 2.3.1. This blog post provides general information to help the reader better understand regenerative medicine, musculoskeletal health, and related subjects. Along with titanium, cobalt chrome is one of the most widely used metals in knee implants. Cobalt is a naturally occurring element in the earth's crust. Because the knee is required to bears a person's full weight on every step, the tibial-knee device joint was inadequate causing the glue to debone and causing further painful bone loss. It is only suggested after the patient has already exhausted all other options, including physical therapy and medication. Another Attune knee problem is the device fails earlier than expected. Knee replacement surgery — also known as knee arthroplasty (ARTH-row-plas-tee) — can help relieve pain and restore function in severely diseased knee joints. Because no two patients have exactly the same tibial bone size or density, the company has updated the information on its website instructing DePuy doctors to rule out potential patients with insufficient tibial bone strength. The friction releases tiny metal particles into your bloodstream that could trigger a hypersensitive immune response in your body. 2.3. Did it, did the follow up therapy and have been happy ever since. This went on for a couple of years. Had my knee done in 2002, age 59. These metals are known to cause skin sensitivity in the general public; about 15 percent of people have nickel sensitivity. 2016 Feb;40(2):239-44. doi: 10.1007/s00264-015-3001-6. and the rate of revision (repair surgery) due to adverse patient’s reactions to metal debris in patients treated with metal-on-metal hinge total knee arthroplasty. 2017 Jan 26:1-6. doi: 10.1080/17453674.2017.1283846. This work won the Alonzo Nuffield Award for the best submitted research paper to the 1992 annual meeting of the Western Orthopedic Association and was published soon thereafter. Tibial base loosening is the primary reason so many DePuy knee come painfully undone, unstable and twists and turn when one walks. Another complication that is causing DePuy knee patient's enough pain and suffering to require revision surgery is having a hypersensitivity to the Cobalt core of the DePuy knee. The effects of cobalt toxicity on the brain are evident. "Total Knee Arthroplasty (TKA) and Unicompartmental Knee Replacement are intended to provide increased patient mobility and reduce pain by replacing the damaged knee joint articulation in patients where there is evidence of sufficient sound bone to seat and support the components." Symptoms include: … … - Hi! He had a terrible time. Frances was 39 when she had cobalt alloy hips implanted. And the devices may also loosen or develop other problems, causing pain and affecting a person's ability to walk. This can cause serious reactions in patients who undergo total knee replacement surgery because some knee replacements are made of cobalt chrome that contains around 1 percent of nickel. Some patients sued. Doctors in Finland have released a new troubling study on the release of metal debris from knee replacement hardware. Finally the doctor replaced the devise with one that had already proven reliable. A study has found that almost 1 in 4 of knee replacement patients who are 60 or older show a decline in activity in at least one brain region 48 hours after surgery. In Portland, Dr. Tower researched the difficult problems that are occasionally encountered after hip or knee replacement. As hip replacements fail and metal flakes enter the body, patients can suffer from cobalt toxicity (elevated cobalt levels). The doctor chose to use a new type of devise for the replacement. In order to fill the space in between the tibia and the sleeve into which the bone is inserted, doctors were told to use "shims" much like a carpenter would when trying to level a set of shelves or a bookcase. Patch testing continues to be a useful tool as laboratory investigations for metal hypersensitivity continue to emerge. We are an out-of-network provider. FINAL DIAGNOSIS. Infection is a severe complication, and it needs immediate medical attention. | 7/24/2017, The Global Market For Knee Replacement | 7/17/2017, Product Failures at Johnson & Johnson | 7/10/2017, Depuy Knee Replacement Side Effects | 7/3/2017, Over 4 Million Knee Replacements in US Alone | 6/19/2017, How Joint Replacement Surgeries Have Become More Dangerous | 6/12/2017, High Demand for Joint Replacement Systems Lead to Defective Products | 6/5/2017, DePuy Knee Replacement System Failures | 6/1/2017. It would seem logical to simply monitor knee replacement patients for raised metal levels, but this is not as simple as it seems. We do not charge attorney fees unless you receive compensation and you are under no obligation after your initial consultation. The devise dislocated at will several times and he developed cobalt poisoning. Doctors in Germany studied patients to determine the prevalence of sensitisation to chromium, cobalt, nickel, or a cement component in patients who received joint replacement surgery. Any further gaps between the bone and the device were filled with glue. Ross Hauser, MD High blood metal ion levels in 19 of 22 patients with metal-on-metal hinge knee replacements. Very small amounts are needed for animals and humans to stay healthy. Attorneys representing DePuy knee cases expect to consult with more patients that have suffered from the complications due to a DePuy knee replacement surgery. Many metal hip replacements were constructed using a hard metal called cobalt in order to extend the life of the hip replacement. October 2, 2014 — A man who had an allergic reaction to cobalt and nickel in the Stryker Triathlon knee replacement has filed a lawsuit in Colorado. Get our FREE 4th Edition Prolotherapy e-book! Throughout my 20's through 50's they put off replacement because I was too young and knees lasted only 8-10 years. Alpha phase titanium has a hexagonal closed-packed (hcp) crystal structure and exists at room temperature. Dr. Steven Tower, an orthopedic surgeon in Alaska, recently gave a fascinating (and alarming) talk about the many neurological problems he has observed in hip patients with elevated cobalt levels in the body. 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. Also for cost of knee replacement Both patients were treated for osteoarthritis with a DePuy ASR (articular surface replacement) XL Acetabular Hip System prosthesis, which contains cobalt and chromium, and which has recently been recalled from the market. It is a very small part of our environment. Longevity depends on many factors including the implant but also on such things how well it is implanted (go to There is little information available concerning the prevalence of and risk factors for these adverse reactions in knee replacements … There has been increasing alarm regarding metal-on-metal joint replacements leading to elevated levels of metal ions and adverse patient’s reactions to metal debris. Cobalt poisoning can occur when you are exposed to large amounts of it. About 1 in 7 show declines across all brain networks. Cobalt poisoning can result in nervous system disorders beginning with tremors in the hand, ringing in the ears, and eventually dementia. The reason for most tibial loosening is the fact that the original DePuy knee is "one size fits all," and fits very few patients perfectly. Titanium has two allotropes: alpha and beta. Metal-on-plastic is the least expensive type of implant and has the longest track record for safety and implant life span. This warning virtually never makes it to a knee replacement consumer, 90% of whom are senior citizens suffering from osteoporosis and osteoarthritis, the exact bone deteriorating conditions surgeons are warned to avoid in patients. Never think about my knee. The most common metal ions found in knee replacement implants that can cause hypersensitivity include nickel, cobalt, and chromium. There is little information available concerning the prevalence of and risk factors for these adverse reactions in knee replacements as opposed to the widely studied metal-on-metal hip joint replacements. Cobalt is a component of vitamin B12, which supports the production of red blood cells. The most common causes are dental or surgical procedures, urinary tract infections and skin infections. It happens when there’s friction between metal surfaces. Replacement knee and hip joints wear out and produce debris that can enter the bloodstream and make a person very sick Thursday, March 28, 2019 - One of the focuses of the Netflix documentary, The Bleeding Edge, is the negative health consequences of "cobalt poisoning" that occurs in metal on metal artificial joints manufactured by DePuy Synthesis. Then with present day technology they do a revision. Had major knee problems from the age of 6. 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The knee replacement implant material used may differ from patient to patient, on the basis of their condition, actual requirement, and also the choice made by the surgeon. How long are titanium cobalt knee replacement suppose to last? Cobalt Toxicity. Int Orthop. The lawsuit (PDF) was allowed to move forward based on failure-to-warn and negligence claims, according to HarrisMartin. We provide free no-obligation DePuy knee lawsuit case review. [Pubmed], 2 Guenther D, Thomas P, Kendoff D, Omar M, Gehrke T, Haasper C. Allergic reactions in arthroplasty: myth or serious problem? It’s caused when the metal wears and introduces cobalt into the bloodstream. We, therefore, discourage the use of metal-on-metal hinge knee replacements. *It does not include vitamin B-12, because cobalt in this essential nutrient is bound to protein and does not release cobalt ions. 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There is no consensus as to which material is better and more suitable. Dr. Tower returned to Anchorage in 1992. 23 percent of participants who had knee replacement surgery showed large declines in brain connectivity. The metals commonly used include cobalt-chromium, titanium, zirconium, and nickel. Epub 2015 Nov 2.[Pubmed]. Revision surgery was needed in 9.8 % of patients with sensitisation to one of the reviewed components. They note: There has been increasing alarm regarding metal-on-metal joint replacements leading to elevated levels of metal ions and adverse patient’s reactions to metal debris. Within weeks, her skin broke out in boils. CONCLUSION: The allergic patient should be thoroughly informed about potential reactions resulting from implant choice, Cobalt and cobalt compounds that release cobalt ions. A good, close friend had hip replacement a few years back. Blood levels. Treatments discussed on this site may or may not work for your specific condition. Some of the metal ions (e.g. The results clearly show that the metal-on-metal hinge knee replacement carries a high risk of increased levels of systemic metal ions and also local adverse patient reactions to metal debris, leading to complicated knee revisions. Others symptoms of Cobalt poisoning are reduced vision and amnesia. Celebrating 28 years of service to those in pain. These are associated with a range of potential health problems including cancer, neurological difficulties and thyroid and heart disease. DePuy knee Cobalt poisoning most often affects one's ability to think and remember things and misdiagnosed in senior citizens as Alzheimer's disease. Titanium and titanium alloys used in hip and knee replacements. | 3/1/2018, Candidates for Knee Replacement | 12/29/2017, Knee Replacement Device Failures | 12/22/2017, Knee Replacement Failure Can Be Life Changing | 12/18/2017, Depuy Knee Replacement Side Effects | 12/15/2017, Johnson and Johnson Past Product Failures | 12/11/2017, People Describe Their Knee Replacement Ordeals | 12/8/2017, The Market For Knee Replacement Devices | 12/4/2017, Arthritis and Knee Replacements | 12/1/2017, What Are The Signs Of Knee Replacement Failure | 9/29/2017, DePuy Knee Replacement Lawyer Handling Claims in All Fifty States | 9/22/2017, DePuy Synthes Targets Senior Citizens for Knee Replacement | 9/15/2017, Knee Replacement Patients Need To Know What Is Wrong With Their Implanted Device | 9/7/2017, DePuy Knee Replacements Fail to Solve Knee Pain | 9/1/2017, Johnson & Johnson's History of Knee Replacement Recalls | 7/31/2017, Do I Need a DePuy Knee Replacement Lawyer? The patient described in the preceding clinical vignette is an excellent example of a concerning medical topic emerging in the current news. Of course technology continues to improve. Acta Orthop. Some people are concerned about developing an allergic reaction to metal implants.