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@sueinmn

May I ask why you are concerned about metal toxicity?

Your posts indicate that you have a recent total knee replacement. I think you are going through the usual trials and tribulations of healing and therapy to get the knee working and have less pain. For most people, this takes from 3 months to a year, depending on their physical condition before surgery and the complexity of your procedure.

A little about metal toxicity in joint replacements - this typically occurs when two metal components rub on one another over time, causing ions to be shed. This was a problem with a specific class of total hips, known as metal-on-metal, which were used on younger patients in the US between about 2003-2007. The theory was that it would take longer for a metal cup to wear out than the traditional metal head on cross-linked polymer cup that is commonly used. But...the metal wore faster than expected, and the body could not completely absorb and excrete it fast enough, leading to elevated levels of chromium and cobalt in the blood and a variety of symptoms.

Now let's talk about knees. Metal-on-metal knee implants are rare. Your surgeon can tell you if you have one. If you have a "traditional" implant, there is a polymer wear layer between the components, so the metal does not rub together. If metallosis occurs, it is typically many years after implant, when that layer begins to wear. I did some quick research, and someone else who was looking at this issue found reference to fewer than 100 cases, most after many years of wear.

If you are still struggling to recover after 5 or more months, I would recommend that you ask for some intensive rehab physical therapy - not the post-surgery "do this exercise, do this stretch..." I mean an evaluation of your knee, your gait and all other issues you are having, then a comprehensive plan to address it.

I think you can set aside your concerns of metal causing your issues.
Sue

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Replies to "May I ask why you are concerned about metal toxicity? Your posts indicate that you have..."

Thank you for your reply. Iit's been 4 months since my TKR, but I have been feeling ill since it was done. (lightheaded, exhausted, occasionally nauseous, etc.) I also have a lot of stiffness & some pain in the knee with walking & standing. I did a cobalt level and it was
0.6, (nl range-0.1-0.4). I was also concerned I might have a metal allergy, (nickel, etc.), that would be apparent immediately, and not require a longer time for the "wear & tear" component to take effect. I do NOT have a "metal on metal" implant, it's a robotic Zimmer with no metal on metal issues, I was told. I don't know how to proceed to see if this is an issue, as my orthopedist dismisses any concerns.

Thanks very much for your reply. I do not have “metal on metal”, I had a robotic Zimmer implant with cobalt/chromium 4/3. I wondered about the possibility of other metal toxicities because I have extreme lightheadedness and exhaustion since surgery 4 months ago, & have seen many doctors, done innumerable scans, labs, etc., all of which have been normal, except for cobalt, which was just slightly elevated. I’m really not functioning well due to these medical issues, and am trying to figure out what is causing my symptoms, which no one else seems to experience for this long. My doctors are puzzled by my symptoms & so am I, & I can’t return to a normal lifestyle.