MUSC Reconstruction Experts Address Metal-on-Metal Joint Replacement Device Controversy
Dr. Harry Demos and Dr. Del Schutte. Dr. Demos and Dr. Schutte, both Associate Professor of Orthopedics at MUSC, and specialists in joint reconstruction recently joined Dr. Marcy Bolster to record a podcast to address concerns regarding metal-on-metal joint replacement devices. Below, please read a summary of their thoughts on device implants and you can listen to their podcast as well.
Dr. Harry Demos, MUSC Orthopaedic Reconstruction Specialist >>>Total hip arthroplasty is one of the most commonly performed and effective surgical procedures currently in use. Nearly 200,000 hip replacements are performed annually in the United States. Recent data reveals hip replacement to be one of the most cost-effective of all surgical procedures in terms of quality of life per health care dollar spent. Unfortunately, newer technology has not always led to an improvement in patient outcomes. A recent hip replacement design has been associated with an unacceptably high early failure rate.
By now almost everyone with a newspaper or television set has seen the advertisements by attorneys soliciting patients with “metal on metal” hip replacements.
While the majority of metal on metal hip replacements may function well for many years, two specific designs have shown significant failures as soon as the first few years. The eventual outcome of other designs remains concerning, recently prompting the FDA to mandate postmarket surveillance to 21 metal on metal hip replacements manufacturers.
Unfortunately these failures if not caught early enough, are associated with significant destruction of the muscles and bone in and around the hip joint. Increased concentrations of metal ions in the blood as well as in the surrounding soft tissues can be readily identified in most of these patients. Some patients, however, have normal metal ion levels and still have problems, while others may have high levels with well-functioning hips. The cause and effect relationship of metal ions and failure remains to be determined, but it is clear at this point that certain designs of metal on metal hip replacements are having a higher than expected rate of failure.
One of the most widely used metal on metal implants that has recently been recalled is the DePuy ASR hip replacement. Approximately 37,000 of these implants have been inserted in patients in the US and 93,000 world-wide. To date, revision rates are around 10%. The revisions associated with failure of the ASR implant can be much more difficult than others and should be performed by surgeons and joint replacement centers who routinely perform revisions. The loss of bone and soft tissues around the hip joint can make reconstruction much more difficult.
Dr. Del Schutte, a MUSC Orthopaedic Reconstruction Specialist reviews x-rays with a patient >>>The implant manufacturer has an aggressive patient care program in place to facilitate and fund revision of any failures of these implants. As with any device failure, this has not happened in the majority of patients with this implant and patients with this implant may have aches and pains which do not in any way portend failure of the implant but are a normal part of life, even with a hip replacement.
We have not recommended the use of metal on metal hip replacement at the MUSC Joint Replacement Center. In the past decade of performing thousands of hip replacement procedures, only two were metal on metal hips; both for very specific indications, both of which are currently doing well. Our lack of embracing this technology is based on our experience with and concern over metal ions — years before these implants were available in the U.S. While marketing of this technology and patient demand have been high, we have continued to use metal or ceramic on crosslinked polyethylene as our implant bearing surface of choice. This bearing combination, along with stem and cup designs with a proven track record of 96-99%, has led to a very low revision rate for our patients. As a tertiary referral center, we frequently perform revision hip replacements. While we are pleased to provide this service to patients who are having problems, we are especially pleased to know that we have not yet performed a single revision hip replacement for a bearing-related issue in a patient who has a metal or ceramic on crosslinked polyethylene hip replacement that was originally performed at MUSC. If you are suffering from hip or other joint pain, please make an appointment today to see one of our orthopaedic specialists.
To learn more about total joint replacement procedures and options visit our video library and listen to additional podcasts on this topic.
Listen now!
Hip Replacement: Metal-on-Metal Hip Replacement Discussion
Hip Replacement: MUSC Hip Replacement Program
hip replacement, joint replacement, knee replacement, orthopaedics, Orthopedics
Related articles
- Australian TGA Response to Recall of DePuy ASR Hip Replacement (earlsview.com)
- McMinn Centre Data Suggests How Bad DePuy ASR was v. Others on the Market (earlsview.com)
- How Long Do Hip Replacements Last? (earlsview.com)
- Associate Professor Michael J. Neil – Doesn’t Recommend Resurfacing (earlsview.com)
- Ceramic Hip Replacement (earlsview.com)
- Hip Implant Removal – Total Hip Revision (earlsview.com)
- ‘Metal on metal’ hip implants leave some recipients in pain, at risk (earlsview.com)
- Anterior Hip Replacements are the Future (earlsview.com)
- Dozens suing over DePuy hip replacement (earlsview.com)
- Mr. Michael Solomon, Sydney Australia Surgeon Gives Advice on Hip Replacement (earlsview.com)
Pingback: Revision Hip Replacement (RHR) « Earl's View
Pingback: Should I Be Concerned if My Hip Replacement Squeaks? « Earl's View
Pingback: 7 Critical Orthopedic and Spine Device Industry Trends « Earl's View
Pingback: The Holy Grail of Orthopaedics – Can We Achieve the Revision-Free Implant? « Earl's View
Pingback: Research Breakthrough for Joint Replacements – Australian Research « Earl's View
Pingback: Hip Replacement A- Z – All you Need to Know « Earl's View
Pingback: Hip Revision A – Z – Comprehensive Review « Earl's View
Pingback: How to Choose a Hip Or Knee Replacement Surgeon & Prosthesis « Earl's View
Pingback: Travel with Confidence – Doctor Devises Microchip to Manage Implant Patient Records « Earl's View
Pingback: Australian Orthopaedic Association National Joint Replacement Registry – Annual Report 2010 « Earl's View
Pingback: Extracts from Australian Orthopaedic Association National Joint Replacement Registry – Annual Report 2010 « Earl's View
Pingback: Metal on Metal Hips – Extracts from Australian Orthopaedic Association National Joint Replacement Registry – Annual Report 2010 « Earl's View
Pingback: Hips and Hip Replacements: What you need to know « Earl's View
Pingback: Bone and Joint Health « Earl's View
Pingback: New Zealand National Joint Registry Eleven Years Data Jan 1999 – 2009 « Earl's View
Pingback: Australian National Joint Registry 2010 – Summary on Hip Replacements « Earl's View
Pingback: Revealed: Britain’s top surgeons for hip replacement « Earl's View
Pingback: Bio-Engineering – Need a new hip? Someday you may grow your own… « Earl's View
Pingback: Derek McMinn addresses Metal on Metal Hip Implants « Earl's View
Pingback: UK NHS Penny-Pinching Hurts Patients – ‘Out of their depth’ nurses block GPs’ patient referrals to hospital for treatment « Earl's View
Pingback: U.S. Marine – Back Into Forward Motion: Advances in Hip Replacement Surgery « Earl's View
Pingback: Arthritis New Zealand urges calm over replacement hip withdrawal « Earl's View
Pingback: Hip Replacement Loosening « Earl's View
Pingback: Hip Implant Complaints Surge, Even as the Dangers Are Studied « Earl's View
Pingback: Pardon my skepticism…DePuy being Promoted by Actress who has had bilateral hip replacement « Earl's View
Pingback: Women most at risk from metal-on-metal hip devices, National Joint Registry Annual Report finds « Earl's View