Does metallosis get better? What helped you?

Hi Joe, Not Colleen here, but a recipient of metal-on-metal (MOM) implants 17 years ago, who had them replaced 11 years ago.

MOM hip implants were developed and approved in Europe around 2000, designed especially for use in younger & more active patients on the theory that the very hard (chromium & cobalt) metals would provide longer wear then the traditional metal or ceramic ball/poly cup liner models in common use. They were approved for use in the US around 2004-5 based on the European approvals, which has been a pretty common practice.

In 2006-2007, surgeons in Europe and the UK began seeing a much higher than predicted rate of failures of these implants, but continued using them and they were slow to share their experience in the ortho world. As a result, surgeons around the world continued to use them, and after a short time the US began to see excess failures as well.

Lawsuits ensued. In 2010 the manufacturers and distributors issued a caution to all surgeons that anyone with MOM implants who was having issues of pain, instability or failure needed to be screened for metallosis and implant failure.

Around 2010 the FDA stepped in to study the issue, and by 2011 the MOM implants stopped being used. As of 2012 FDA requires additional PMA (Pre Market Authorization) of any MOM devices being used or proposed.

As of today, there are no MOM total hip replacement devices approved, or requesting approval. There are just two MOM hip resurfacing devices (a much less invasive surgery) that went through approval and are on the market.

So, there are many people (in the thousands) who still have MOM hips, many without issue. There are also some who are now experiencing issues & getting them replaced. The reasons for why some work fine & others fail are probably varied, but one that is known is that they are much more "picky" about placement - with the polymer liner, there is some tolerance in acetabular cup positioning, with the harder metals, perfect placement was crucial.

My surgeon really thought he was doing the "right thing" to give me a longer-lasting joint, but as time proved, newer is not always better!

Fortunately, it did lead to a valuable policy change in the approval of devices by the FDA.
Sue

Just diagnosed with failure of polyethylene liner to chromium cap. My hip replacement (2010) has slipped out of socket and I am awaiting a revision in three weeks. Trying not to move too much as am terrified of the cobalt/chromium leakage that may (is) ensuing. And I had it done (2010) at number one hospital in US. So much we do not know as patients.

No need to fear "chromium/cobalt leakage" - that is not how it occurs, and surely not in a time as short as 3 weeks. Your implant was not "metal on metal", but rather the more traditional metal/poly - and probably the insert in the pelvis is titanium.
The metal poisoning that some of us experienced was when a cobalt liner was used (without poly), and the chromium and cobalt wore against each other over time (4 years or longer) releasing minute bits of the metal into our tissue. By 2010, virtually no surgeon was using the combination any longer as the problems began to show up, first in the UK & parts of Europe, then in the US.
Relax, rest easy, and good luck with your revision!
Sue

Good morning @srwolfe and welcome to Mayo Connect. I'm sure you have a lot of people here scratching their heads and thinking "What's metallosis, and what does it have to do with hip replacement?" - But that's the beauty of having 100,000 plus members to ask - some member on here is likely to have had experience with just about any issue you can name.

For those not familiar, there was a period when, instead of the traditional metal/ceramic/polymer hip implants, which typically wear out in about 20 years, it was believed that implants made entirely of metal would prove longer lasting, especially for younger or very active people. Sadly, for about half of the implant recipients, the rubbing of the two surfaces wore off an extraordinary amount of metal, which deposited in the tissues around the hip and eventually made it into the bloodstream. This resulted in metallosis, often referred to as chromium/cobalt poisoning, and resulted in pain, hip instability, implant failure, and many other unpleasant symptoms. The only cure is to remove and replace the implants with more traditional materials.

Eleven years ago, I had my metal-on-metal hip implants replaced for this very reason. Instead of pseudo-tumors, my muscle & fat tissue had just degenerated into something the surgeon described as "lumpy gray oatmeal." And yes, there was quite a bit of discomfort as the tissue healed. It gradually subsided until at 6 months it was completely gone. As I recall, the things that helped were temporarily replacing one walk a day with some simple stretches, gentle massage of the sore area and ice 3 times a day. After the second replacement, I got quite a bit of PT, including in the pool, and "gait training" to correct the imbalances the bad implants had caused, and I had to replace my shoes - especially the walking shoes. At my check in May I was told the new replacements look great, and they feel fine too.

Which implants did they remove for you? How long did you have them, and what brought you to the surgeon? Did you treat yourself to new walking shoes for your rehab?
Sue

I had metal on metal implants in bilaterally in 2009. I had a terrible case of Metallosis in which I behaved in a crazy manner and was completely out of control. I ruined my professional reputation. It was horrible. I hate that it ever happened to me. If you have metalosis, do NOT try to work. Keep to yourself until you see how it is impacting you. No doctors warned me of these symptoms and I’ve lived to regret it every day.