What Are High Metal Levels and Why Should I Care?

High Metal Levels and Metal-on-Metal Hip Implants

There’s been a lot of buzz in the news lately about metal-on-metal hip implants. Most people are talking about their dangerous side effects. The fact of the matter is, patients with metal-on-metal hip implants often have increased levels of metal in their blood. But how does this happen? Why does it matter? And who knew about it?

How can I get metal in my blood?

A traditional hip implant is composed of two main parts: a ball (femoral head), and a socket (acetabulum). If the hip implant is metal-on-metal, then the ball and the socket are both made of metal. Specifically, hip implants are made from cobalt and chromium. As a hip-implant patient moves their legs, the implant’s metal ball rubs against its metal socket. This rubbing of metal ball against metal socket causes metal particles to shave off and leak out into the patient’s body. These leaked metal particles build up in the patient’s blood, soft tissue, and other organs and as a result increases the body’s metal levels. Because metal-on-metal hip implants are made of cobalt and chromium, the metal particles in the patient’s body also contain cobalt and chromium.

A second type of hip replacement is a modular system. A modular hip replacement system generally consists of four or more interchangeable parts: a socket (acetabulum), ball (femoral head), neck (femoral neck), and stem (femoral stem). Unlike traditional metal-on-metal hip implants, the interchangeable parts present additional opportunity for metal-on-metal wear and corrosion. Corrosion and wear between parts also leads to metal – cobalt and chromium – particles being shed into the patient’s body.

Why can high metal levels be bad?

An increased metal level in the body can be very dangerous for the patient because it can cause metallosis (metal poisoning). And metallosis can in turn cause:


Like patients, hip implants come in different shapes and sizes. Surgeons try to use the hip implant that’s best sized for each specific patient. Then, during implant surgery, the surgeon hammers the ball and neck tightly into the femur (leg bone), and screws the cup tightly into the pelvis. When a patient develops pseudo tumors, necrosis, and osteolysis, their hip implant can loosen. Consequently, a loose implant increases the patient’s risk of dislocating their hip or fracturing their femur.


Not only is hip dislocation very painful for the patient, but it can be dangerous because it could cause the patient to fall. Leg fracture is similarly very painful and dangerous. If a patient’s hip implant loosens, they’ll need revision surgery to remove and replace it with a new implant that has a proper fit. In sum, metallosis is a painful side effect of a defective hip implant and patients who get it often need hip revision surgery.

Adverse effects of high metal levels are not new knowledge

Scientists first discovered that metal-on-metal hip implants cause metallosis in 1971. Manufacturers learned shortly thereafter and reduced the production and sale of these implants in the late 1970s and early 1980s. Then in the late 1980s, manufacturers claimed they’d invented a new generation of metal-on-metal hip implants which didn’t cause metallosis. Surgeons began implanting the new generation of metal-on-metal hips into patients, and for a while, all seemed to be well. But then in the 2000s, scientists began completing their studies on the second generation metal-on-metal hip implants. The results were not good. Overwhelmingly, studies show that the new generation of metal-on-metal hip implants is just as dangerous as the old. Not only do scientists recognize that these metal-on-metal hip implants are dangerous, now the government, and juries are realizing it too. For example, a court in Texas just awarded six metal-on-metal hip implant patients $1 billion. Additionally, the Food and Drug Administration (FDA) has issued multiple safety alerts and recalls of metal-on-metal hip implants in the last 10 years. Some manufactures have voluntarily stopped producing metal-on-metal hip implants, and others have recalled the hip implants themselves.

What should I ask my doctor about high metal levels?

If you’re not sure whether your hip implant is metal-on-metal, call and ask your doctor.. If you know that you have a metal-on-metal hip implant, call your doctor immediately and schedule an appointment to get your cobalt and chromium levels measured. Pseudo tumor, necrosis, and osteolysis can all be painful. But they can also be painless. So you can’t really know whether you have increased metal levels unless you get tested.

If you are diagnosed with high metal levels or need a second surgery after your initial hip replacement, please call GoldenbergLaw for a free initial consultation.