High Chromium Levels in a Hip Replacement Patient
Is there such a thing as hip replacement chromium poisoning? I’ve blogged before about how wear particles in all types of joint replacements can make their way into the blood stream. Researchers have found metal ions in the blood of knee replacement patients. They also now advise allergy testing against the most common metals used in hip and knee replacements (including chromium), as many patients were found to be allergic. I frankly have never had a first hand experience with this issue, reading the research in the abstract like most physicians. However, recently a patient came in with a hip replacement and asked me to check his chromium levels. I obliged, frankly unsure as to what I would find. I thought maybe his levels would be slightly elevated if at all. I was blown away when it came back as above, almost 3 times the upper limits of normal! How much is too much? Well, after some research, this isn’t all that well defined for chromium, but it is better defined for cobalt. We will be measuring his cobalt levels, as these two go in tandem for hip replacement patients. Below is the list of symptoms related to toxicity for both:
Box 1: Some reported symptoms of arthroprosthetic cobaltism7
The upshot? These elevated levels of serum cobalt and chromium are for real, so if you’ve had a joint replacement, getting them checked may be a good idea.