Cobalt suffer from prosthesis?
This blood test measures any excess cobalt in blood due to metal-on-metal (M-o-M) hip replacements or other exposures (glass and ceramic industries, cement and carbide production ).
In mid-2010, British orthopedists reported that some patients with so-called metal-on-metal hip replacements, consisting of a large metal head and metal socket, may develop symptoms. These complaints may result from very small metal particles released as a result of normal locomotor activity, which can cause a local inflammatory reaction of the tissues surrounding the hip in some patients. Elevated concentrations of the metal cobalt may also occur in the blood. Although initially it seemed to only involve metal-on-metal hip replacements of a particular brand, it has now become clear that other brands of metal-on-metal hip replacements can also cause these problems.
Frequently asked questions about metal-on-metal hip replacements
What is a metal-on-metal hip replacement?
An artificial hip or total hip prosthesis consists of a head and a socket that can both be made of the same or different materials, such as plastic, metal or ceramic. The diameter of the cup may vary . A metal-on-metal hip replacement involves a large head (diameter 36 millimeters or larger) and a socket, both of which are made of metal.
Who has received a metal-on-metal hip replacement?
The most common form of total hip replacement is a metal or ceramic head in a plastic bowl. It is known that a plastic bowl can wear out over time, and especially in younger patients, the lifespan of a hip prosthesis is generally shorter than in the elderly due to more intensive use and causing more wear and tear. Therefore, much research has been done on more wear-resistant materials to improve prosthesis longevity in younger patients. In this regard, the use of a metal-on-metal prosthesis seemed to be an attractive option because of its demonstrated wear resistance. In addition, the use of a larger head increases the stability of the hip prosthesis, thereby reducing the risk of luxation (the dislocation of the hip head). Therefore, metal-on-metal hip replacements have been used in our hospital almost exclusively in young patients (i.e., younger than 65 years of age) and patients with an active lifestyle. In a few cases, the metal-on-metal prosthesis has been used in older patients because of its greater stability.
What problems can arise with a metal-on-metal hip replacement?
Only a limited number of patients develop symptoms. As you move, wear and tear can occur on the hip prosthesis, which can release small metal particles. In some patients, this irritates the tissue around the prosthesis and can cause swelling. This can be painful, but as far as we know, it poses no immediate health risks. These swellings are also called pseudo-tumors. The swelling is not malignant, but is a kind of hypersensitivity reaction that can cause symptoms around the hip, groin, on the side of the hip or in the buttock. In addition, in some patients the concentration of the metal cobalt in the blood may be elevated. In the case of very severely elevated cobalt levels in the blood, possibly abnormalities of thyroid, heart or nerves may develop, but such high blood cobalt concentrations have so far not been described in patients with a metal-on-metal prosthesis, if at all. No relationship of elevated blood cobalt levels to the development of cancer has been demonstrated at this time.
Does this problem affect all brands of metal-on-metal hips?
In 2010, it became known that some patients with metal-on-metal hip replacements may experience pain symptoms. At first, it seemed to concern only hip replacements of certain brands, but it has since become clear that the problem is no longer related to any particular brand.
Does everyone with a metal-on-metal hip replacement experience symptoms?
Every person is different and therefore reacts differently to any metal grinding. What is clear is that most patients are symptom-free.
Cobalt is considered a carcinogen. It is used in the glass and ceramic industries as well as in cement and carbide production.
Chronic poisoning lead to: contact allergy (jewelry?), Contact eczema, anemia, polyglobulia, heart muscle damage, asthmatic symptoms after inhalation
polyglobulia is a disorder in which the level of red blood cells (erythrocytes) in the blood: the hematocrit, is too high. It is thus the opposite of anemia (anemia).
Testing method: inductively coupled plasma - mass spectrometry
This allows the determination of metals and some non-metals, with very high sensitivity. Recognition of concentrations of 10-12 grams per liter are possible.
Frequency 2x per week (number of times an analysis is used in a given period)
Conversion factor µg/l x 16.97 = nmol/l
Reference value(s)
0 - 11.0 nmol/l
The result is good if it is below 10.2.
This test is also available from urine on request.
Although cobalt is part of vitamin B12, and a shortage of cobalt - and therefore of vitamin B12 - can cause anemia, this test is not suitable for measuring a B12 deficiency. Vitamin B12 is also called cobalamin. In cobalamin the word cobalt is hidden. But to measure this you better measureHolo-Transcobalamin
This test is used for companies to monitor the Cobalt load
Cobalt is considered a carcinogen. It is used in the glass and ceramic industries, as well as in cement and carbide production. Chronic intoxication: contact allergy (jewelry?), contact eczema, anemia, polycytemia, heart damage, asthmatic symptoms after inhalation.
