Cobalt Chromium Toxicity

Increased Risk of Complications with Stryker Accolade


The Stryker Accolade is associated with an elevated rate of implant migration and loosening. There are clinic factors which contribute to the increased likelihood of complications and subsequent failure of the hips: aseptic loosening of the femoral component was associated with implant instability and micro motion (excessive motion at the implant-bone interface). Hip implant complications significantly affects patient function, results in hip implant failure and a need for revision surgery.

 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3254738/pdf/11999_2011_Article_2160.pdf

Hip Surgery: The Importance of Doctor-Patient Communication


An open and honest dialogue with your doctor before surgery contributes to better outcomes. This means providing your physician with a comprehensive medical, surgical, and social history. This also ensures the doctor gives you the best care in creating a plan that fits your specific needs. Before any surgery, it is essential to voice any questions or concerns you might have.

The American Academy of Orthopedic Surgeons (AAOS) created a list of questions which may help in discussions with your doctor:

  • What are your experiences with specific hip implant devices and how often do you use one over the other?
  • What are the risks and benefits of different devices (metal-on-metal, metal-on-polyethylene, ceramic-on-polyethylene, and ceramic-on-ceramic devices)?
  • If applicable, what is the surgeon’s personal experience and outcomes with the respective devices?
  • If your surgeon recommends a certain device, ask why that hip implant is the best for your situation.
  • What are the major and/or most frequent complications of surgery?
  • Is the skill and experience of the orthopaedic surgeon more important than the device or procedure?
  • Can you give me any information on outcomes and complication rates?
  • If I do not have surgery, what is the risk?
  • How much pain can I expect, and how will it be managed in the hospital and after I go home?
  • How long will the device last, and what can I do to make it last as long as possible?
  • What are the pros and cons of minimally invasive (mini-incision) surgery? Does it really make a meaningful difference in the result, or does it pose unnecessary risks?
  • What will I be able to do/not do after my total joint replacement?
  • Is therapy necessary after surgery?
  • How long will I be in the hospital?
  • Will I be able to contact you after the surgery if I have a question or problem?

What should I do if I have a metal on metal hip?


A series of product recalls involving prosthetic hips occurred recently. The design of these hips led to the release of toxic levels of cobalt and chromium (the metal the hips are made of) into the patients who receive them.  These metals cause extensive tissue damage in the hip and other areas of the body. This usually requires additional surgery to repair. Kershaw, Cook & Talley currently handles cases involving the following types of hips: DePuy PinnacleDePuy ASRStryker AccoladeStryker Rejuvenate, Stryker ABG IIBiomet, and Wright Medical.

Many individuals are unsure what to do when they find out their metal on metal hip is defective or recalled. Kershaw, Cook & Talley recommends the following steps:

A) Find out what name and model hip you have. There are various ways to do this:

  1. Contact your orthopedic surgeon by phone. 
  2. Request a copy of your medical records in writing from the orthopedic surgeon’s office or hospital where the surgery was performed. 
  3. Check your implant card. Often times, after surgery, your doctor gives you an implant card which states the hip name and type. 


B) Check to see if your hip implant was officially recalled (if not, you may still have a case).

  1. You might have received a recall letter notifying you that your hip implant was recalled. 
  2. If you did not receive a letter, ask your doctor if your hip implant was recalled. 


C) Have your blood tested for cobalt and chromium:

  1. Tell your doctor you want to get your blood tested specifically for cobalt and chromium. 


D) Get a MARS MRI:

  1. MARS MRI stands for Metal Artifact Reduction Sequence MRIA MARS MRI is an imaging technique which minimizes metal artifact (i.e. parts of the implant) while maintaining image quality.
  2. You will most likely have to request this imaging study from your orthopedic surgeon. 

F) Call our office for a free case consultation and if you have any more questions regarding your metal-on-metal hip. 

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