← Return to Cobalt levels in blood
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Bones, Joints & Muscles | Last Active: Jul 30 9:26am | Replies (39)
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← Return to Cobalt levels in blood
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First, let me assure you that not everyone with metal-on-metal hip implants has problems. The current numbers are thought to be 30-50%
Normal blood serum levels of chromium and cobalt ions should be below 2ppb (parts per billion). Have your blood serum levels of chromium and cobalt ions checked whether or not you have symptoms. Older guidelines said up to 7ppb were acceptable, but more recent guidance sets the levels at 5ppb. This test can be ordered by your original orthopedic surgeon or by your primary provider, but must usually be sent out to a specialty lab.
If you have no symptoms of failure, and metal ions are below 5ppb, baseline imaging should be done to determine if changes are happening. And you should be rescreened every year, or every 3-6 months if there are physical signs of deterioration or serum levels begin to rise.
However, absence of symptoms does not mean there is not damage occurring. Next steps vary depending upon whether you have symptoms of excess metal ions & particles shedding or not.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6985013/
If you have symptoms of a problem - pain, loosening of the implant, evidence of tissue breakdown, there is a comprehensive protocol to follow which includes a physical examination and current medical history, imaging and bloodwork.
Here is a comprehensive article published 4 years ago in the Journal of Clinical Orthopedic Trauma:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6985013/
So the answer is, "it depends". If you are okay, get checked to establish a baseline, and monitored periodically to make sure you don't develop issues.
On the other hand, if you have elevated metal levels and tissue breakdown, consider revision sooner rather than later - this is not something that will get better or go away - and metal poisoning and tissue breakdown can have serious health consequences.
Are you having problems with your implants?