DePuy Hip Implant Failures and Chromium Blood Risks
Author: Thomas C. Weiss
Published: 2013/01/15 - Updated: 2026/02/22
Publication Type: Informative
Category Topic: Bones and Joints - Related Publications
Contents: Synopsis - Introduction - Main - Insights, Updates
Synopsis: This information examines the documented problems with DePuy Orthopedics metal on metal hip implants - specifically the ASR and Pinnacle models - including premature device failure, the release of microscopic metal shards into the bloodstream, and the resulting health condition known as metallosis. Written by Thomas C. Weiss, a researcher holding a Masters degree and experience in disability care, the article draws on reporting from the New York Times, FDA approval records, warnings issued by DePuy Orthopedics to physicians, and advocacy efforts by the US Drug Watchdog urging implant recipients to undergo blood testing for elevated chromium and cobalt levels. It details the design defect responsible for implant loosening, the serious complications associated with revision surgery, and the medications that can interact with chromium absorption. For people with hip replacements, older adults who are among the most common recipients of these devices, and individuals living with disabilities related to joint failure, this is a practical resource covering both the medical risks and the steps affected patients can take to protect their health - Disabled World (DW).
- Topic Definition: Metallosis
Metallosis is a form of metal poisoning that occurs when microscopic particles of metal are released from an implanted medical device - most commonly a metal on metal hip replacement - into the surrounding tissue and bloodstream. In the case of DePuy ASR and Pinnacle hip implants, a design characteristic involving minimal clearance between the metal head and cup components causes friction during normal body movement, generating tiny metal shards composed primarily of chromium and cobalt that accumulate in soft tissue and circulate through the blood. This accumulation can lead to a range of serious health consequences including chronic pain, inflammation, bone loss, local tissue necrosis, tumor formation, genotoxicity and premature loosening or complete failure of the implant, often requiring complex and painful revision surgery to correct.
Introduction
DePuy Hip Implants and Chromium Metal Dangers
March of the year 2010 found the New York Times reporting that DePuy Orthopedics had warned doctors that its ASR hip replacement cup, also referred to as a, "socket," was failing in people within a few years after hip replacement surgery when the implants should have been expected to last fifteen years or more. The failures may lead to expensive and highly painful replacement operations called, "revision operations." The Food and Drug Administration approved DePuy's ASR implant cup and metal ball for use in America in the year 2005. There are approximately 140,000 people in America who have received a DePuy metal on metal hip implant.
The US Drug Watchdog's goal is to get every DePuy Pinnacle hip implant recipient identified to an attorney because if the implant has failed, or is failing, the person who received the implant may have elevated levels of chromium in their blood. While several thousand people have signed up for a class action because of the failure of their DePuy hip implant, the numbers of people who have are not nearly enough. The US Drug Watchdog believes the numbers should be over seventy thousand. Europe is suggesting failure rates of metal hip implants of fifty-percent.
Main Content
Health Risks Related to Chromium
The presence of few serious adverse effects linked to a high intake of chromium finds the Institute of Medicine failing to establish a, 'Tolerable Upper Intake Level (UL),' for the mineral. A, 'UL,' is the maximum daily intake of a nutrient that is unlikely to cause adverse health effects. A UL is one of the values that comprise the Dietary Reference Intakes for each nutrient, along with the RDA and AI. Chromium may; however, interact with some medications.
Certain medications might interact with chromium, particularly if a person takes them on a regular basis. It is important to check with a doctor before taking dietary supplements; especially if prescription medications or over-the-counter medications are also something the person takes. The following medications alter a person's stomach acidity and might impair chromium absorption, or enhance its secretion:
- Antacids
- Corticosteroids
- H2 Blockers such as famotidine, cimetidine, rantidine, and nizatidine
- Proton-pump inhibitors such as lansoprazole, omeprazole, pantoprazole, rabeprazole, and esomeprazole
Certain medications can have their effects enhanced if they are taken along with chromium, or they might increase the absorption of chromium. These medications include the following:
- Insulin
- Nicotinic acid
- Corticosteroids
- Beta-blockers such as propranolol or atenolol
- Non-steroidal anti-inflammatory drugs (NSAIDS)
- Prostaglandin inhibitors such as ibuprofen, naproxen, indomethacin, aspirin, and piroxicam
The US Drug Watchdog does not want people who have received a DePuy metal on metal hip implant to find themselves paying the costs for the premature failure of their implant. The group is encouraging people who have the implants to get a blood test to find out if they have an elevated level of cobalt, or chromium in their blood.
Issues with the DePuy Hip Implant
Issues people have experienced with the DePuy implant include pain, swelling, and difficulties with walking. If the symptoms are persistent they may be signs of a loose or even a detached implant, fracture of the bone around it, or dislocation of the implant's components.
A revision surgery to replace a defective DePuy hip implant may be long and complex and is more likely to result in complications that the original surgery. The reason is because there is a reduced amount of bone for a surgeon to work with due to the loss of bone during the original implant procedure. People who receive revision surgery to replace a hip implant are nearly four times as likely to experience a dislocated hip.
Unfortunately, the implant has failed in many people and has required revision repeatedly. The defect in the DePuy hip implant is due to its minimal clearance, which is the space the space between the outer diameter of the head of the device and the inner diameter of the shaft. Small clearances become an issue in relation to shifting and loosening of the cup or the femoral stem.
Sadly, due to the minimal or inadequate clearance, a person's usual body movement creates torque which is detrimental to the cup and stem of the implant and may lead to early loosening and excessive wear and tear on to the implant. The DePuy Pinnacle metal implant devices are failing at high rates. The clearance on the product is similar to the low clearance levels of the DePuy ASR device.
Dangers Associated with the DePuy Pinnacle Hip Implant
The issue with metal on metal hip replacement products is the design may cause the metal components to rub together and result in microscopic shards of metal being deposited into a person's bloodstream. The deposited shards of metal may also result in damage to surrounding soft tissues, inflammation, and bone loss. The damage to surrounding areas of a person's body may lead to a premature loosening of the implant components and eventually - failure of the implant itself.
The most common complaint related to the DePuy Pinnacle implant is premature loosening of the implant, although more serious issues have been known to happen. Specifically, some people have experienced bacterial infections, particularly people who are elderly or obese, as well as the formation of blood clots. Blood clots can result in damage to a person's cardiovascular system.
The most concerning risk is related to blood metal poisoning referred to as, 'metallosis,' a condition where shards of metal are deposited from the implant into the person's bloodstream. Signs and symptoms of metallosis can include the following:
- Pain
- Tumors
- Bone loss
- Genotoxicity
- Inflammation
- Local necrosis
- Aseptic fibrosis
- Walking difficulties
- Soft tissue damage
- Increased levels of chromium and cobalt in a person's blood
People who endure a DePuy Pinnacle hip implant failure commonly have to also undergo a painful revision surgery to correct the failure. Revision surgeries are many times more complicated and difficult, as well as being more painful than the original implantation surgery. Even more, failure of these implants are often times associated with damages to surrounding bone and tissues in a person's body, something that ultimately makes the person's rehabilitation process more difficult too. If you or someone you love has received a DePuy hip implant, please contact the US Drug Watchdog immediately.
Insights, Analysis, and Developments
Editorial Note: The DePuy hip implant story is a case study in what happens when a medical device with a fundamental design flaw reaches approximately 140,000 patients before the scope of the problem becomes clear. The minimal clearance between the implant's components - a seemingly small engineering detail - translated into real suffering for thousands of people who experienced pain, bone loss, metallosis and the ordeal of revision surgery that is far more difficult and risky than the procedure they originally underwent. What makes this situation particularly troubling for disabled and elderly populations is that these are the very people most likely to receive hip implants and least able to absorb the physical toll of repeated surgeries and prolonged rehabilitation. The US Drug Watchdog's push to get every Pinnacle recipient tested for chromium and cobalt blood levels reflects an uncomfortable truth about medical device oversight - that patients themselves often become the last line of defense in identifying a failing product, long after the regulatory and manufacturing systems that were supposed to protect them have fallen short - Disabled World (DW).
Author Credentials: Thomas C. Weiss is a researcher and editor for Disabled World. Thomas attended college and university courses earning a Masters, Bachelors and two Associate degrees, as well as pursing Disability Studies. As a CNA Thomas has providing care for people with all forms of disabilities. Explore Thomas' complete biography for comprehensive insights into his background, expertise, and accomplishments.