Tuesday, April 3, 2012

Metal ion levels decrease after revision for metallosis arising from large-diameter metal-on-metal hip arthroplasty


 J Orthop Res. 2012 Mar 23. doi: 10.1002/jor.22107. [Epub ahead of print]


Royal Liverpool and Broadgreen University Hospital, Liverpool, United Kingdom.


Concerns have been renewed regarding the possible long-term effects of elevated circulating levels of cobalt and chromium as a direct result of implantation of large femoral head diameter metal-on-metal bearings. In order to establish whether metal ion levels remain persistently elevated, we compared metal ion levels before and after revision surgery in patients with large head diameter (greater than 38 mm) metal-on-metal total hip arthroplasty or hip resurfacing arthroplasty. At greater than one year post removal of a large-diameter metal-on-metal hip implant for the indication of symptomatic metallosis, metal ion levels were found to fall to almost normal levels.

[I have wondered how long it would take to get the blood levels back to normal.  it appears that the answer is about a year.  I recently published my blood levels 5 months post op and the metal content had dropped by 50%.  thought this was an interesting finding.]


  1. I am very interested in any data you may have regarding the blood levels getting back to normal. I am 11 months post revision; my cobalt levels is almost back to normal from 169.9 to 2.2 at 11 months post op. My chromium level is not dropping as quickly; it was 80 prior to revision, dropped to in the 30's 3 months post op, 25.9 months post op and 25.1 at 11 months. I am concerned of consequences from long term exposure. I had extensive gluteus medius necrosis discovered at revision.

  2. I think you have every right to be conceerned. Here is the link to my levels so you have some comparison:



  3. Hi Connie
    I did see your post op levels. I am still waiting for my whole blood levels to come back at which time I will get a call from my surgeon. My biggest concern seems to be the lack of knowledge regarding the metal levels. Are you aware of any experts in this field? Is there anyone monitoring patients like us?
    My hip was the Depuy Pinnacle MoM, original surgery 7/2005. Everything was great for the first 2 - 1/2 years when I started having noises and increasing pain. My original surgeon kept telling me nothing was wrong for 3+ years. He never got metal levels. I am still have pain post revision but it is different; groin pain that is mostly positional, burning in the lateral portion of the butt and hip mostly after exercise, and localized pain in my anterolateral mid thigh which occurs randomly. Aside from a call from my surgeon with the metal levels, he said the pain is common and the only treatment option is pain management and that he would not need to see me for two years! I walk with a cane because of the extreme weakness from gluteus medius damage which the surgeon and PT feel will not improve beyond this point. I am 58 now and have always been very active. Travel, golfing and scuba diving are my passions and are all now limited if at all.
    Thanks for listening to me.

  4. Hi, Yes there are experts in the field but you have to travel to see them. What city are you in?

    You must be seen to have the metals taken. Can you send me your location via e-mail. I won't publish it but will send you someone with whom you can make an appointment.

    I can totally understand your frustration but you must stick to your guns. You must go see someone else.

    Send me your location and I wil advise via e-mail but will not post.

    So sorry you are having these issues. LMK if I can be of further help once you send me the city or state you are located in.



    1. Hi Connie
      Thsnks for your reply. I can't seem to find your email address.

  5. Hi,

    just send it to the one you are using. I do not have automated publishing so I can recieve and e-mail and answer it without publishing it.