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 a metal socket, may develop symptoms. These complaints can be caused by very small metal particles that are released as a result of normal movement activity and that can cause a local inflammatory reaction in the tissues around the hip in some patients. Increased concentrations of the metal cobalt in the blood can also occur. Although initially it seemed that only one brand of metal-on-metal hip replacements was affected, it has since become clear that other brands of metal-on-metal hip replacements can also cause these problems.
Frequently Asked Questions about Metal-on-Metal Hip ReplacementsWhat
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, for example plastic, metal or ceramic. The diameter of the head can 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 well known that a plastic bowl can wear out over time, and especially in younger patients, the life span of a hip replacement is generally shorter than in older people due to more intensive use and resulting in more wear. Therefore, much research has been done on more wear-resistant materials to improve the life of prostheses 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, thus reducing the risk of luxation (dislocation of the hip head). The metal-on-metal hip replacements have therefore been used in our hospital almost exclusively in young patients (i.e. under 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 prosthesis?
Only a limited group of patients develop symptoms. When you move, the hip prosthesis can wear down, releasing small metal particles. In some patients this can irritate the tissue around the prosthesis and cause swelling. This can be painful, but as far as we know it poses no immediate health risk. 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. Very elevated levels of cobalt in the blood may cause thyroid, heart or nerve abnormalities, but such elevated blood cobalt concentrations have so far not been described in patients with a metal-on-metal prosthesis. No relation to the development of cancer has been demonstrated for elevated levels of cobalt in the blood.
Does this problem occur with all brands of metal-on-metal hips?
In 2010 it became known that some patients with a metal-on-metal hip prosthesis may experience pain. At first it seemed to concern only certain brands of hip replacements, but now it has become clear that the problem is no longer related to a certain brand.
Does everyone with a metal-on-metal hip prosthesis get complaints?
Every person is different and therefore reacts differently to any metal wear. What is clear is that most patients are complaint free.
Cobalt is considered a carcinogen. It is used in the glass and ceramic industry 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 spectrometryThis 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/lReference value
0 - 11.0 nmol/lThe
result is good if 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