An abundance of recent research has drawn attention to the potential toxic effects of elements associated with metal alloy hip implants and prosthesis devices.
David Quig, PhD, Vice President of Scientific Support for Doctor’s Data, Inc, laboratories wrote an opinion paper in this month’s Townsend Letter, January, 2018.
He states it is well established that levels of metals in the blood are increased indefinitely following all types of metal-on-metal Total Hip Arthroplasty procedures and there are indeed local and systemic tissue responses. Moreover, there is no acceptable threshold above which blood levels of metals such as cobalt, chromium, and titanium are known to be toxic.
Until very recently, the vast majority of prosthesis consisted of pairings of alloys of cobalt (Co), chromium (Cr), and molybdenum (Mo) for the acetabular cap and femoral head. The femoral head is attached to a femoral stem/shaft that is composed of titanium alloy with vanadium.
Healthcare practitioners are concerned with the remote tissue deposition and potential systemic toxic effects of the incompatible metal debris from the excessive wear and failure of the implants.
Local inflammation, excessive oxidative stress, low levels of glutatione and compromised redox protection are seen in laboratory studies. Cobalt and Chromium particles/ions accumulate in lymph nodes, cause nerve toxicity, and heart problems. Signs and symptoms may include visual and hearing impairment, tinnitus, vertigo, heart pathology, mental problems/dementia, mood disorders, hypothyroidism, peripheral neuropathy and skin rashes.
Titanium particles concentrate in the spleen, lungs, heart, kidney and liver. Vanadium interferes with a vast array of biochemical reactions.
The most fundamental rule of toxicology is to eliminate the exposure. Removal of the metal implant would go a long way to lower the exposure. However, patients that do not have this option must deal with the perpetual exposure to the offending metals.
Chelation therapy should be given serious consideration for managing the perpetual release of Co and Cr and associated pro-oxidative effects of the metal implants. EDTA has been shown to be the most effective chelator of Co, Cr, Ti, and V.
It is also proposed that a protocol including dietary/supplemental antioxidants, and metal conjugating agents (eg. liposomal GSH, N-AC) along with the chelation intermittently may greatly help the potential local and systemic toxic effects associated with the life-long exposure of these metals.
“Iatrogenic Metal Burdens“, by David Quig, PhD, Townsend Letter, January, 2018, pp.31-35.