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Metallosis Health Scare
The last couple of years has brought so much change and happiness with marrying my High School Sweetheart and then building our dream home overlooking Grand Junction, CO. However, 2024 started off with a bout of Shingles as I turned 70 and finished up with a couple cases of Covid. But all was trending to great with my first annual ski pass at Powderhorn.
At the beginning of March of 2025 I experienced what seemed like a Kidney Stone due to centralized pain in the lower back and abdomen. After a visit with my doctor and a blood test for Cobalt, I realized that I was undergoing a Metallosis event from my 2 Wright CONSERVE® Femoral Resurfacing which are made from Chrome/Cobalt. My hips were resurfaced in 2006 and 2010 and I have been extremely happy with the results which allowed me to continue my love for backpacking. I did experience a Metallosis event back in 2016 when I took up playing my beloved game of Handball. I quickly realized that the lateral movement of this court game was causing metal fatigue in my hips confirmed by a high concentration of chrome/cobalt in my blood. When I realized the similarity of symptoms with this latest event my “A-Ha” Moment pointed directly at the amount of skiing I had done this winter. I didn’t equate lateral movement with skiing, however, after thinking about the stress put on hips from skiing, I knew what I had done.
After my first encounter with Metallosis, I scrambled to understand more about health ramifications from metal poisoning and it was scary. I had friends with hip resurfacing who shared with me their terrible experiences of tissue dying around their hips that were somewhat confirmed by the Documentary: “The Bleeding Edge” that I wrote a post about. Luckily it appeared that my specific brand of hips had a superior metal alloy and design which limited the amount of metal fatigue. But I was not sure how much damage had been done from the skiing. I was definitely in severe pain for many weeks but I was not sure how much permanent damage had been done. In my earlier research I found that the over the counter supplement N-Acetyl-Cysteine, NAC, was a natural chelating agent for your blood. (An earlier Post about NAC) It was OK to increase my dosage of NAC from 1200 to 2400 mg which I did along with shutting down my exercise routines that did not sit well with my almost 1 year old Labrador Retriever or my golf game.
The severe pain began to subside and I was able to walk the dog again, I was daily monitoring the muscle cramping and weakness of the muscles around my hips. The slow but steady progress through March was encouraging and now I am able to walk 18 holes of golf at least once a week in April. I have an appointment with a Orthopedic Surgeon in May when I hope to get more deliberate about a maintenance program for monitoring the metal fatigue. (Update)I met with my Orthopedic Doctor to discuss my MRI of my hips and all looks good. No reason to be concerned so now I can exercise without fear of doing more damage. Overall, it appears that I will be able to manage this problem and continue my plans for a return to Backpacking.
Using NAC to Remove Chrome/Cobalt from Blood
I have 2 Birmingham Resurfaced Hips (BHR) made of Chrome/Cobalt. The first in 2006 and the second in 2010. I first posted about this situation after watching the documentary film “The Bleeding Edge” on Netflix. Since then my concern has only heightened due to the potential of chrome/cobalt poisoning in my blood and tissue from metal fatigue realized from these metal hips. I have friends who have experienced the horrible effects from this heavy metal poisoning so I have monitored my own situation closely in recent years. In this post I wanted to share how the use of the supplement N-Acetyl-Cysteine, NAC, has actually decreased the levels of Chrome/Cobalt in my body.
My History: My family has shown a propensity toward the development of an arthritis that creates some bone deposits in our hips. For me this has been accelerated by a life of sports activity, most notably basketball, that allowed this arthritic condition to wear away the natural lining of my hip joint. Once I understood this back in 2006 when I was 52 years old and in constant pain I had to figure out a solution. I had heard that hip replacements were good for 15-20 years which did not seem to match well with my age. I remember hearing about hip resurfacing in a 60 Minutes type segment on Americans traveling to India for this surgery. So I started investigating this alternative procedure. The allure for me was the fact that you could remain active and if needed down the road I could still get a hip replacement. Fortunate for me there was an orthopedic surgeon in Salem, Oregon, who was allowed to perform this surgery probably due to the FDA’s 510(k) pathway for approving medical devices. My first hip was his 439th hip resurfacing. I do believe that my second hip done in 2010 was from the same design and stock of the Cobalt-chrome implant.
Near the end of 2015 I returned to playing Handball which I had played a lot in my 20’s. However, I quickly realized that handball was causing new pain around my hips. I had my first heavy metals blood/urine test was done in 2016 which showed that my levels were higher then normal but still within a safe range. My tests in 2021 showed that these levels had not come down but still no serious worries except that it seemed to me that my muscles around my hips were not recovering as quickly from heavy backpacking exertion as they used to. In 2021 my doctor asked if I wanted to explore blood chelation therapy to remove heavy metals from my blood. That seemed a bit excessive, but I appreciated the advice and so I set out to investigate other options to achieve this chelation. Of course the Internet provided a wealth of information that once deciphered led me to try taking the natural health supplement N-Acetyl-Cysteine which provided the chelation of heavy metals in my blood to be disposed of via urination.
I did give up playing handball which I believe contributed undue metal fatigue stress on my hips that I hypothesize is due to the lateral motion. This may have also disturbed the normal wear on the hips that has come from my extensive backpacking.
During my recent physical exam in June of 2022 by doctor was very pleased with the progress that had been made with my Chrome/Cobalt numbers. Chrome is really the major concern for me and my test results went from 2.4 mcg/L in 3/21 to 1.9 mcg/L in 6/22. I have to admit that I was fairly nervous about getting these test results back because I felt like I had really pushed my aging body over that period of time. After completing the Lost Coast Trail in 2/22 I felt like my recovery took longer so I focused my discipline to take the recommended dosage 1200 mg of NAC over 24 hours. It appears that it contributed to the lowering of chrome/cobalt levels in my body. This awakening along with a major life change has caused me to backoff on extensive backpacking treks.
These articles in “N-Acetyl-Cysteine Reduces Blood Chromium and Cobalt Levels in Metal-on-Metal Hip Arthroplasty“, “N-Acetyl-Cysteine as Effective and Safe Chelating Agent in Metal-on-Metal Hip-Implanted Patients: Two Cases“, seemed to be somewhat straightforward in describing the advantages of NAC.
Nothing overly scientific presented in my post, but I thought it was important to at least reference my outcomes on the Internet. My resurfaced hips are still providing me with a positive lifestyle. The Adventure Continues.
Hip Perspectives on “The Bleeding Edge” Documentary
After watching the documentary film “The Bleeding Edge” on Netflix I thought I should weigh in as a patient who has had both of my hips resurfaced, meaning my hip joints are metal on metal ball and sockets.
My 2006 Right Hip
The film is a very well done documentary that examines the $400bn medical device industry that reviews five products that have exhibited significant failures including the broad review of cobalt based hip implants. This is an important documentary that does expose the weakness of our regulation of the medical implant industry and sounds a needed alarm to those patients who may now be at risk.
I am focusing on hip resurfacing which was lumped into the broad exposure of any metal joints made from Cobalt. The greatest concern comes from these devices that actually operate with a metal on metal joint, and hips are probably the most common. My hips are made of a Cobalt-chrome alloy that is used because it creates one of the hardest and strongest metals known to man. These features are critical for a successful and enduring joint replacement. The premise for using a metal on metal hip as in my case is that the body naturally encapsulates and provides lubrication for the joint movement. The Co-Cr alloys show high resistance to corrosion due to the spontaneous formation of a protective passive film composed of mostly Cr2O3. The minor amounts of cobalt and other metal oxides on the surface appear to be contained by the body’s encapsulation. The documentary does not spell this out in sufficient detail, instead it broadly classifies any device made from cobalt as dangerous.
My History: My family has shown a propensity toward the development of an arthritis that creates some bone deposits in our hips. For me this has been accelerated by a life of sports activity, most notably basketball, that allowed this arthritic condition to wear away the natural lining of my hip joint. Once I understood this back in 2006 when I was 52 years old and in constant pain I had to figure out a solution. I had heard that hip replacements were good for 15-20 years which did not seem to match well with my age. I remember hearing about hip resurfacing in a 60 Minutes type segment on Americans traveling to India for this surgery. So I started investigating this alternative procedure. The allure for me was the fact that you could remain active and if needed down the road I could still get a hip replacement. Fortunate for me there was an orthopedic surgeon in Salem, Oregon, who was allowed to perform this surgery probably due to the FDA’s 510(k) pathway for approving medical devices as mentioned in the documentary. My first hip was his 439th hip resurfacing. I do believe that my second hip done in 2010 was from the same design and stock of the Cobalt-chrome implant.
I guess the point of my post is to let it be known that hip resurfacing can be very positive. So why have I not experienced any cobalt poisoning related medical issues? Obviously the surgery can be positive, however, it is true that many have experienced serious problems. Depuy, owned by Johnson & Johnson, was referenced in the documentary, however, there has been recall activity on cobalt based joints from Stryker and Smith Nephew. My theory for my success is based on the fact that the hips that were used for me were created in the early pre FDA approval period. I have asked who made my hips and I never got an real answer. They appear to be similar to the Smith Nephew BHR and the Wright Conserve systems. Maybe those early test hip parts were done with more attention given to the metallurgy involved. Possibly my success has to due with my lifestyle. I have learned that I cannot participate in physical activity that is based on radical lateral movement such as basketball or handball. What I can do is walk or backpack which I have done to the tune of about 2000 miles since my second hip surgery. So overall I am extremely thankful for this medical hip resurfacing technology.
I do hope that the FDA is able to improve the overall approval process for medical device technologies and it is good that documentaries are made to help bring attention to these needs. But we must also caution against blanket assumptions made to help sensationalize a documentary, such as all devices made with cobalt are bad for you.
The Adventure Continues 