What is Considered a High Metal Level?
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Cobalt and Chromium Metal Poisoning from Hip Replacements

Reaction to cobalt and chromium debris from metal on metal hip replacement

Heavy metal poisoning is a risk factor for anyone who has a metal on metal (MoM) hip implant.  Corrosion from microscopic metal particles in your bloodstream could trigger a hypersensitive immune response in your body.

Your doctor or surgeon will most likely test your blood for metal toxicity. If you have a MoM hip implant and have not gotten bloodwork done yet, you should ask your doctor about it right away.

Why Blood Testing is Critical

Many leading orthopedic surgeons recommend that patients with metal on metal hip replacements undergo cobalt and chromium blood testing every three months for as long as they have a metal on metal implant.

Cobalt and chromium blood testing is critical, even if you don’t have any symptoms or physical issues with your hip.   Here’s why:  The friction from the metal cup and stem rubbing together can cause extremely small metal particles to break off and spread through your bloodstream and can result in devastating side effects.

What Is Considered a High Level of Chromium and Cobalt?

It’s important to remember that slightly elevated metal levels are normal for patients who have metal on metal hip implants, but excessively elevated levels are very alarming.  DePuy Orthopedics, Inc. released a report stating that concentrations greater than 7 parts per billion of cobalt and/or chromium are of concern. The Mayo Clinic has set a much lower reference value for blood testing, listed below.

High Chromium Levels: Greater than 1ng/mL

According to the Mayo Clinic Medical Laboratories, “blood serum concentrations greater than 1ng/mL in a patient with Cr-based implant suggest significant prosthesis wear.” Their research also indicates that these levels increase the longer you have the hip implant.

High Cobalt Levels: Greater than 10ng/mL

Additionally, the Mayo Clinic Medical Laboratories reports that “cobalt is not highly toxic, but large doses will produce adverse clinical manifestations. Toxic concentrations are greater than or equal to 5.0 ng/mL.  Serum concentrations greater than 10ng/mL in a patient with cobalt-based implant suggest significant prosthesis wear.”

Interpreting the Results

Laboratories, research studies, and other reports about metal ion release often use different measurements. That makes it confusing for patients to compare and understand their own test results.  The good news is that most of these measurements are equivalent and represent the same thing:

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What Should I Do If I Have Elevated Metal Levels?

See your orthopedic surgeon and primary care physician immediately.  This is a situation that requires long-term medical monitoring. If your concentration of cobalt and chromium remains above a safe level, your doctor will probably recommend a MARS MRI and/or ultrasound and more testing.  If not, you may want to request these advanced tests from your doctor, even if you don’t have any symptoms.

What if I Don’t Have Any Symptoms?

Often there are no immediate physical signs of a problem, but the hidden damage that these metals can do to your body is traumatic.  The earlier you get medical care, the better. Read more about the different types of adverse reactions below.

Video of Metallosis Reaction During Hip Revision Surgery

Sometimes the best way to understand severe metal reactions is to see for yourself.

The image below shows a still shot of metallic colored fluid gushing from the surgical area near the hip implant. Click the photo to see the full video of research done on adverse tissue reactions from metal on metal hips.

In this research, the patient is a 70-year-old man who reported swelling in his hip. During the revision surgery, doctors punctured the fluid-filled tissue surrounding the muscles of the hip to find a surprising amount of discolored fluid, along with corrosion at the head-neck junction of the hip implant. The pathology report confirmed it was an adverse local tissue reaction (ALTR) from the metal on metal hip implant.


Adverse Reaction to Metal Debris (ARMD)

ARMD describes general complications to metal debris in the body from corrosion in a metal on metal (MoM) hip implant.

The researcher who coined the term “ARMD” used it to describe all the different types of soft tissue damage found in patients with MoM hips, including metallosis, pseudotumors, and ALVAL.

Our Extensive Legal Experience in Metal on Metal Hip Litigation

➨ Maglio Christopher & Toale, P.A. is one of only a handful of law firms in the nation that has reviewed the millions of discovery documents involved in this type of litigation. Other law firms contact our attorneys for advice on these types of cases.

➨ Our attorneys have personally questioned under oath dozens of orthopedic hip manufacturer’s employees from all over the world, including surgeons, designers, marketing executives, and corporate CEOs.

➨ In 2008 Maglio Christopher & Toale, P.A. filed the first lawsuit in the United States against a manufacturer of the current generation of defective metal-on-metal hip replacements. Ever since we have been at the forefront of litigation against the makers of these defective medical devices across the United States.

➨ We have developed contacts within the orthopedic community, an understanding of how that community works, and we have extensive medical and technical knowledge about defective orthopedic hip replacements.

➨ Our attorneys are aggressively and actively litigating defective metal on metal hip cases through the U.S. state and federal court systems.  We are not waiting for a settlement that may never come because our clients need help now.

Talk to Us Now About Your MoM Hip Situation

Meet Our Metal on Metal Hip Legal Team

MCT Law has focused its practice on defective hip replacement cases for over a decade.  Our attorneys aggressively litigate these cases for clients across the entire country.  We are a national law firm, and can represent you in any state or US protectorate.

William Christopher, Of Counsel

William Christopher, Of Counsel


Michael J. Cowgill

Michael J. Cowgill


Theodore J. Hong, Esq.

Theodore J. Hong, Esq.


Altom M. Maglio, Esq.

Altom M. Maglio, Esq.

Managing Partner

Ilyas Sayeg, Esq.

Ilyas Sayeg, Esq.


Michele S. Stephan, Esq.

Michele S. Stephan, Esq.


Metal on Metal Hip Replacement Lawsuits Cobalt Chromium Toxicity