Hip resurfacing

This is my Chromium test results from the lab, CHROMIUM, PLASMA
HI
17.5 nmol/L
This is what is considered normal 2.5-6.0 nmol/L This is all very confusing to me as you are measuring in (ppb)

That is high - 3x the top end of the normal range. Has your serum cobalt been measured as well?

I had the Birmingham Resurfacing done and it served me well for 17 years. I had to have Girdlestone Procedure done in 2022 due to infection. I would advise you to get consult with Orthopedic Surgeon who specializes in Revisions as soon as possible. I wish you all the best.....Cindy

I agree but after reaching out to the drs none have been able to tell me a way of bringing it down. I don't think my serum cobalt has been measured they just say chromium plasma but I am not sure what that means either. Hope that when I see my Dr next week she will be able to enlighten me. I am told the only way to get rid of the Chromium is to get the problem removed from my body. I have one hip resurfacing and the other was replaced plus I have had 2 shoulder replacements, all due to arthritis. Does that mean I need to get all 4 joints removed? I am really starting to be worried about what this is doing to my body.

They need to identify which implant had a chromium wear surface. It is most likely one of the hips. Serum cobalt levels should also be measured, elevated levels can cause problems with your heart, central nervous system and thyroid among others. If you had a Birmingham resurfacing, these have been identified as a source of metalosis as they wear. If the full implant is what is known as metal-on-metal, both wear surfaces are metal, typically chromium and cobalt. As they rub against one another, metal ions are shed into the body - more than can be eliminated by blood, liver & kidneys. This continues until the offending parts are removed.
I'm not aware of any shoulder implants that have had this issue.
There is a process called chelation, where chemicals are used to try to eliminate the chromium from your body. BUT the wear continues to produce more - the only solution is replacement. There is no effective chelation therapy for cobalt except time -once the source is gone, your body excretes the excess.
Do you know what kind of total hip implant you have?

I have no idea if it was a Birmingham resurfacing. Do you have any idea where I would find this information. My operative report does mention I had a Wright medical Conserve Plus. At the time of surgery I was told it was a Johnson & Johnson.

That particular implant, from a different manufacturer, has been linked to chromium cobalt toxicity and other issues. It was recalled in 2016 and you should have been notified by the surgeon and tested then. Wright Medical was the manufacturer; Johnson & Johnson was primarily the marketer of a variety of implants.

If your total hip replacement was done before 2016, you should find out which one it is too.

Please get your doctor to do a serum cobalt blood test as well. Have you gotten an appointment with a revision surgeon yet?

I have 15 and 16 year old Birmingham hip resurfacings that are causing immense pain now. Getting a doctor to do anything has proved futile so far.
I have limited ROM in the right, the older, and it often squeaks like a rusty hinge with each step. Cobalt and chjromium levels have been high since they were put in...Not super high but around 10.
Can anyone reccomend a revision surgeon in the Syracuse / Cortland/Binhamton areas.
Dr. Lawrence Weisner had agreed to do them, but is now ghosting me. Also have nerve involvment and just immense pain.

I keep losing my reply this morning - how high is your chromium level? Is your cobalt level also elevated?
NAC is N-acetyl cysteine, a precursor of glutathione, which is helps remove some excess metal ions from the body. It works on chromium, but not cobalt. The study cited above reported reduced chromium in people whose level was 2-3 times normal (normal is less than 1 part per billion.)

I went through revision for failed metal-on-metal implants 12 years ago, and my levels of both chromium and cobalt were in the toxic range - recovery to normal levels took about a year and left me with a few long-term health issues. I urge you to get the problem removed as soon as you can. Your body will thank you.

PS When you request testing, ask for both chromium and SERUM cobalt to be screened.
Here are the normal and elevated levels;
Cobalt Normal .8 micrograms/liter
Elevated 2 micrograms/liter
Toxic 5 micrograms/liter
Chromiun Normal < 1 parts per billion (ppb)
Elevated > 7 ppb
Concern > 50 ppb