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As reported previously, in the first lawsuit to go to trial involving all-metal hips made by J&J's DePuy unit, testimony was presented later in the week by a toxicologist. The DePuy ASR trial is currently underway in Los Angeles Superior Court.

What is Metallosis?

The lynchpin of the problem with metal on metal hips, is the propensity of the device to shed metallic debris. And it is this metallic debris which accumulates in the hip joint and is absorbed in the bloodstream, that is the source of the illness associated with metal on metal hips. This toxic effect of the metallic debris works both locally in the hip joint and when absorbed, that gives rise to a medical condition known as metallosis. Simply put, there is too much heavy metals in the body, often leading to deleterious side effects.

Here in the case at trial, heavy metal cobalt and chromium toxicity caused by debris meant that the device had to be removed from the plaintiff. Robert Harrison said "I concluded that his hip failed because of the toxic exposure," the expert is an occupational medicine specialist at the University of California, San Francisco.

More than 10,000 U.S. lawsuits have been filed since the hips were recalled from the market in 2010. As many as 500,000 Americans are estimated to have received metal-on-metal hip replacements. Plaintiff Kransky's blood tests showed that his levels of cobalt and chromium reached as much as seven times normal after he received the ASR hip.

Earlier in the week, DePuy executives explained that the ASR hip was tested in the laboratory at a single angle of implantation. Plaintiffs' lawyers contend that they should have tested it using multiple angles. All-metal hip implants were supposed and marketed to be more durable than older implants with ceramic or plastic components, but they have been shown to fail at a higher rate than traditional implants.

A J&J internal study presented at the trial showed that the company had estimated that 37 percent of the devices would fail within about five years of implant surgery.

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