Normal levels?

[Denver_wrench]

I was just told by my Dr. that my blood test results are as follows: No cobalt detected (minimal levels), chromium at 0.8. He sounded pretty happy about that, as am I. I expected high levels at 6 weeks post-op but there we have it.

[Tommy]

Do you know what high levels of cobalt/chromium would be?

[Denver_wrench]

My admittedly limited understanding of this is that both levels can be as high as 10 ug/L within the first year.

[Tin Soldier]

I've seen anything less than or equal to 4 ug/L as a good number for Co.  That came from Pritchett's paper on MoM and metallosis.  I didn't see anything in there on Cr, yet some folks on here have suggested what normal levels would be for Cr and I believe it's in the 0.5 to 1 ug/L range.  In Pritchett's paper he recommends looking into potential metallosis if Co is above 100 ug/L and if there are other signs, like pain. 

[Tommy]

Thanks for the info does any one know what pain from Co would feel like. Where can I find Pritchett's paper.

[Tin Soldier]

There's a number of papers on the subject, but one that folks tend to look at is Pritchett's paper, because it's fairly general, but still pretty involved.  It's in the link below.

For pain, it would not be specific to the metal, it would simply be inflammation from the excessive metals in the hip area.  I think you'll see some posts about psuedotumor and bursa and those sorts of issues.  I don't think there is any real specific pin point locations where you would expect to find the beginning of metallosis, I think it tends to come with pain in the hip area for no good reason.  Pritchett's paper talks about how it generally presents itself.  It's one of those things we all sort of worry about a little, but I think it's actually pretty uncommon.  Pat's webpage on the subject has a lot of good info, also.

http://www.pritchettorthopedics.com/articles.php

[Tommy]

Dr. Pritchett's paper has some good info thanks for turning me on to it.
                                                                          Tommy

[Lopsided]

This comes from the other resurfacing site, in turn from McMinn:

The MHRA (medicines and healthcare products regulatory agency) the statutory body that regulates resurfacing devices in the UK advocates the figure of 119 nmol/L cobalt (or 7 parts per billion, ppb) for resurfacings. This was not arrived at, by performing the kind of pharmacokinetic tests that are carried out for drug toxicity. It was based on the distribution and variations of cobalt levels in patients with well-functioning metal-on-metal (MoM) resurfacing. Levels above this do not indicate systemic toxicity. They have used it more as a rough guide to identify potential cases for local debris related reactions only. 

It is suggested that it is reasonable to reassure patients with less than 7ppb that they had a well functioning MOM hip and monitor those with greater than 7ppb. It does not mean that this level causes systemic toxicity. It only implies that among patients who develop a local reaction the blood levels are often greater than 7ppb.

[mdmdale]

I know this is old on here but I’m having issues. My hip bone death was found to be from 3 shots of cortisone. Two on one buttcheek and one on the other. I was checked for all other known causes. I feel like since I’m so sensitive to many medications, maybe I’m also sensitive to low levels of these metals. I’m seeing yet another dr soon.