Metallosis is one major side effect. Metallosis is the accumulation of metal debris in the soft tissues of the body. Symptoms of metallosis include metal toxicity, bone deterioration, pain, swelling and inflammation, pseudotumors (fluid-filled collection within periprosthetic tissues), and loosening, dislocation or fracture of the implant. Metal joint implants, such as the DePuy Pinnacle, significantly increased the incidence of metallosis in the last 40 years. Metallosis may involve hip, knee, shoulder, elbow or wrist joint replacements.
Metal toxicity (cobalt-chromium toxicity) is another common side effect. Metal toxicity occurs when metal components of the hip implant grind together and release metal particles into the blood stream. There is potential for long term health problems associated with metal toxicity. Blood metal analysis tests for elevated blood levels of cobalt and chromium. Individuals with the DePuy Pinnacle should request ongoing, consistent monitoring of their blood metal levels.
Side effects from metal toxicity include:
- vision or hearing loss
- cardiomyopathy (weakening of the heart muscle)
- cognitive impairment
- peripheral neuropathy (nerve damage)
- shortness of breath
We recommend anyone implanted with the DePuy Pinnacle undergo a MARS MRI, or a
Metal Artifact Reduction Sequence MRI. A MARS MRI is an imaging technique which minimizes metal artifact (i.e. parts of the implant) while maintaining image quality. It is utilized to detect adverse local tissue reactions (ALTRs) and adverse reaction to metal debris (ARMD). Mayo Clinic describes ARMD as, "Implant-specific local and systemic adverse effects related to sensitivity to the metal or due to the wear of the metal surfaces themselves...serum chromium and cobalt concentrations correlate with ARMD."
Side effects from adverse reaction to metal debris (ARMD) include:
- soft tissue damage
- groin and buttock pain
- implant loosening
- device failure
- damage to bone, muscle, and nerves
- infection (requires joint aspiration)
- irritation and impingement
- need for revision surgery