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CIHI Study Reveals Problems with Metal-on-Metal Hip Implants

On July 18, 2013, the Canadian Institute for Health Information (CIHI) released the results of a study aimed at examining the longevity of artificial hip implants. Researchers studied outcomes of more than 59,000 hip replacement surgeries performed in Canada between 2003 and 2011. Data was included from all the Canadian provinces, with the exception of Quebec.

Researchers found that patients who were implanted with a large-diameter modular metal-on-metal hip implant device had a 5.9% chance of needing revision surgery within five years after the original procedure. Patients who received other types of hip implant devices had a 2.7% chance of requiring revision surgery during that same time frame.

Cost of revision hip replacement surgery

According to researchers, cost and recovery time for revision surgery is much higher and much longer than patients’ original hip replacement surgery. CIHI says that patients having revision surgery remain in the hospital 17% longer and pay 45% more than they did during their initial hospitalization and rehabilitation.

Who gets metal-on-metal hip implants?

The majority of patients receiving metal-on-metal hip implants were men under the age of 55. Similar numbers have been found in studies conducted in Australia and the U.K. The metal-on-metal implants were originally marketed to this patient demographic, since they were highly touted for their increased mobility and durability.

“Metal-on-metal hip replacement implants were generally considered to be the most suitable implants for younger, more active patients who were traditionally at higher risk of repeat surgery due to the wear and tear they place on the implant,” Dr. Eric Bohm, orthopedic surgeon from the Concordia Hip and Knee Institute, was quoted as saying in the Canadian Institute of Health report.

Unfortunately, the choice to go with a metal-on-metal hip implant did not prove beneficial for some of those patients, as complications with the implants resulted in pain, reduced mobility and the need for subsequent surgery. In addition, CBC/Radio-Canada recently reported that some patients receiving these implants suffered tissue damage around the joint, after metal particles entered surrounding tissue and the bloodstream.

Legal trouble for makers of hip devices

In 2010, Johnson & Johnson issued a worldwide recall of its iconic metal-on-metal stars, DePuy ASR XL Acetabular System and the ASR Resurfacing System. A few short months after the recall was issued, the first class action lawsuit involving DePuy devices was filed in Quebec Superior Court.

Complaints about the devices include misalignment, loosening of the joint, dislocation, fracture, and metal debris around the joint. Plaintiffs have claimed that DePuy was aware of the potential problems with their devices, but refused to pull the devices from the market before patients were injured by the implants.

It is estimated that as many as 4,000 DePuy ASR hip implants have been used in Canadian patients. Over 37,000 of the devices were implanted in patients in the United States where the device manufacturer is also facing widespread and growing litigation.

Devices remain in wide use

Researchers in this recent study primarily focused on the large-diameter modular device. These devices feature a metal ball that fits inside a larger-than-normal metal socket. The purpose of the design was to improve mobility in younger, more active patients. Unfortunately, some surgeons have found the design is also more sensitive to malposition, which can increase the risk of metal particles rubbing off the device and entering the bloodstream.

The use of metal-on-metal hip implants appeared to peak between 2007 and 2008, but has been gradually decreasing since that time. Researchers in this study found the metal-on-metal devices only represented around 10% of the total number of devices examined. Metal-on-plastic devices were used in nearly three-fourths of the surgeries studied, and continue to be a popular choice for surgeons and patients today with seemingly fewer complications.


Lance Andrews

Lance Andrews writes for Injury Lawyer News, where he reports on the effects of dangerous drugs and medical devices as well as recalled products. He is committed raising awareness about these issues to protect patient safety and consumer rights. His unique point of view comes from a combined education in journalism and medical studies.

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