Does metallosis get better? What helped you?

Posted by srwolfe @srwolfe, Sep 20, 2022

I had a hip revision done two months ago. My problem is bilateral hip metallosis with pseudo tumors. I was rehabbing really great walking a mile a day three times a day until last week. Saw my Dr for my two month checkup and he says everything looks and feels great. I told him I have developed pain and a tugging in my groin area. He told me that happens sometimes due to the tissue damage the metal causes and it will get better. very painful especially at night. Any others with similar situation?

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aldonacharlton | @aldonacharlton | Mar 7, 2023

In reply to @sueinmn "Hi Joe, Not Colleen here, but a recipient of metal-on-metal (MOM) implants 17 years ago, who..." + (show)

@sueinmn

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

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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.

Sue, Volunteer Mentor | @sueinmn | Mar 8, 2023

In reply to @aldonacharlton "Just diagnosed with failure of polyethylene liner to chromium cap. My hip replacement (2010) has slipped..." + (show)

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

aldonacharlton | @aldonacharlton | Mar 8, 2023

In reply to @sueinmn "No need to fear "chromium/cobalt leakage" - that is not how it occurs, and surely not..." + (show)

Thank you Sue. Appreciate your taking the time to reassure me. Be well.

katietinco | @katietinco | Oct 5, 2023

I had my MOM hip implant replaced about 8 years ago. At the time, the tissue around it tested positive for infection, I had elevated cobalt levels, and an odd rash that no doctor thought could be attributed to the MOM but I always did. And the rash has never gone away completely, at least not for more than a week.

Fast forward to Jan 2023 and I went to the ER with what I was afraid might be a stroke - severe headache and blurred vision with a couple of "starbursts" in my eyes, primarily on the right side. After ultrasounds, CTs and MRIs, they found 2 nodules on my thyroid and a meningioma (brain tumor of sorts). Neurosurgeon said to watch & wait with the meningioma and I had a partial thyroidectomy in April to remove the nodules. (Figured out the sensation of feeling like a pill was stuck in my throat and my consistent hoarseness was from the nodules.) Both nodules were benign.

In Sept, similar symptoms in my neck/throat area but nothing showing up in the remaining thyroid on ultrasound. Still waiting for an appointment with the doctor I was referred to for next steps on that but PCP couldn’t explain what might be the cause. And my headaches have become more frequent and more severe.

For the majority of the last few years, I've had severe fatigue and brain fog that I attributed to my sleep apnea despite it being "treated" and my overall sleep numbers looking good. We even moved because being at sea level seemed to help with both of those but that seems to have only been a short-term effect. I started researching things again and discovered I'm not the only one with all of these things going on after a MOM implant.

I was hoping to get an appointment with Mayo so I could get a more coordinated approach since the fragmented care I've received for the last 8 years has been frustrating to say the least, and it sounded like Mayo has handled similar cases but I heard today that they won't take me.

I'll keep fighting to figure out what’s going on but as I’m sure others here understand, it’s frustrating. I'm tired - tired of fighting this battle, tired of trying to figure out what will make me feel better for more than a week at a time, tired of bitching and moaning about my medical problems, and tired of being tired. I want my life back.

I’m in the Nashville area so if anyone has experience with any medical providers who were able to help with metallosis, I’d love to find out more. Thanks!

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