Hip implant recipients who
received a metal-on-metal device may have a significant number of potential
health issues to be concerned with. When the metal components of the implant
rub against one another microscopic metal ions can be released into the body.
This can be a serious matter for any patient however some patients are more
sensitive to metals than others. This may explain why some hip implant patients
with a relatively low amount of metals in the body can become extremely ill
while others with much higher levels may have few adverse symptoms. The
generally accepted “cutoff” point for the danger level of metals is seven parts
per billion (The normal, healthy person will have levels between .19 and .4).
This is a rather arbitrary number in that lower numbers can be just as
dangerous in a recalled Stryker Rejuvenate or ABGII because of their unique
design.
While any patient with symptoms
of metal poisoning should definitely undergo blood tests to confirm the levels
of metals although interpreting those results can be tricky. There are a number
of variables which factor into deciphering the metal levels in a hip implant
recipient including the patient’s age and gender, symptoms and, of course, the
specific type of hip implant. The typical symptoms of metal poisoning include:
gastrointestinal, renal, thyroid, cardiovascular and neurological issued, skin
rashes, elevated risks of cancer, pseudo-tumors, DNA mutations, vertigo, vision
and hearing loss, depression, anxiety, irritability and memory loss.
Metal Sensitivities Which Contribute to Hip Recall Symptoms
Metal sensitivities can
contribute greatly to the symptoms experienced by those with metal hip
implants. The Journal of Investigative Dermatology puts the number of people
who experience some degree of sensitivity to nickel at approximately thirty
percent. Some of those people will be severely allergic to nickel and will have
violent reactions to virtually any exposure to nickel. Hip implants which are
constructed of cobalt and chromium contain around one percent nickel. When the
metal ions shear away from the implant, a certain number of nickel ions will
also be transported throughout the body. A person with a severe nickel allergy
who undergoes artificial hip implantation with a device made of cobalt and
chromium could suffer extreme damage to the liver and kidneys.
Others who have metal
sensitivities but not in the extreme can initially have fairly vague symptoms
such as mild swelling, redness, fever, eczema and rashes with no other
explanation. As time goes on and more metal ions enter the hip tissues and
bloodstream, the allergic reactions will increase in severity. Chronic pain will
occur as well as significant inflammation of the hip tissues. These in turn can
lead to loss of mobility as well as implant failure as it pulls away from bone.
Those patients who experience this level of hip recall symptoms may have little
choice but to undergo painful and potentially risky revision surgery.
How Metal-on-Metal Hip Implants Can Lead to ALVAL
An extreme hypersensitive
response to a metal-on-metal hip implant is known as ALVAL or Aseptic
Lymphocyte dominated Vasculitis Associated Lesion. While doctors do not
completely understand the ALVAL phenomenon it has been suggested that there may
be a link between bone loss and ALVAL. When a patient has suffered chronic
groin pain—particularly when that pain restricts the normal day-to-day activities—ALVAL
may be suspected and tests for infection considered. Should the groin pain
persist yet infection be absent, the physician may nonetheless recommend
revision surgery and a new implant of a different substance.
When ALVAL is suspected the
doctor will perform an exam, take a thorough patient history as well as x-rays
and MRI. During a revision surgery a microbiological and histological analysis
can prove the presence of ALVAL. Many doctors consider ALVAL to be
under-diagnosed because of the fairly non-specific symptoms. One specific
characteristic of ALVAL lies in the painful straight leg raise which is likely
due to excess fluid around the joint. Among patients suspected of suffering
from ALVAL, fluid withdrawn from the hip is generally a greenish gray color and
a thicker viscosity. Any recipient of a metal hip implant such as the recalled
Stryker Rejuvenate or ABGII who has hip recall symptoms should see their
physician as soon as possible. Those with no overt symptoms should also have
regular testing done to determine the levels of metals in their body.
