Earl's View » knee replacement

Consumer Reports Urges a Lemon Law For Joint Replacements

earlstevens58 — Thu, 17 Oct 2013 21:30:03 +0000

Consumer Reports Urges a Lemon Law For Joint Replacements

by Christy Rakoczy, a J.D.

Manufacturers of hip and knee replacement products made many promises to consumers. This is especially true of DePuy Orthopaedics, Stryker, Zimmer and other manufacturers of the new generation of joint replacement products largely marketed as medical devices that would last longer and provide more flexibility than traditional joint replacement solutions.

Unfortunately, the marketing for many of the new hip replacement products may have turned out to be a lot of hype. In fact, many of the hip replacement products that came on the market in recent years not only fail to last longer but actually appear to have higher failure rates and may cause serious complications for many patients. The extensive problems that patients allege they’ve experienced has even caused Consumer Reports to call for a “lemon law,” on replacement joints.

Consumer Reports Calls for a Warranty On Artificial Hips and Knees

Consumers Union, the policy arm of Consumer Reports, argues that medical device manufacturers should give consumers a warranty on hip and knee replacement products, promising to replace the medical devices at no costs. This suggestion comes at a time when as many as 20 percent of all hip replacement procedures and 10 percent of all knee replacement procedures each year are revision surgeries that are necessary because of problems with the implanted artificial joint.

Consumer Reports believes a warranty would both be fairer to patients who need to undergo repeated surgeries and would prompt medical device manufacturers to make sure their products are safer and more durable.

While this idea has merit as a method of protecting customers, unfortunately a warranty may not be enough. Those whose artificial joints fail often experience significant pain and serious medical complications. A no-cost revision surgery wouldn’t compensate the victims of defective medical devices for these other losses, but a product liability claim can and does allow patients to take action for defective hip and knee replacement devices.

Patients Have Rights When Hip and Knee Products are Defective

A large part of the reason revision surgeries have become so common in recent years is that many of the newer hip replacement products are metal-on-metal devices that were brought to the market under a special FDA rule.

The FDA’s 501(K) clearance rules allow manufacturers to produce and sell medical devices with a fast-tracked approval process and minimal testing provided there are substantially similar devices on the market already. Unfortunately, many of the devices brought to market under these rules have now been recalled when it turned out the products weren’t so safe after all.

DePuy Orthopaedics, for example, instituted a voluntary recall of its ASR™ Hip System after data from a UK joint replacement registry indicated a higher-than-average failure rate. The Stryker Rejuvenate and ABG II Modular-Neck Hip Systems were also recalled because of high failure rates.

The FDA continues to review the safety and efficacy record of metal on metal hip implants. The agency continues to receive adverse event reports with regard to the devices. Commonly alleged problems include:

Aseptic loosening
Infection
Bone loss
Metallosis (a/k/a “metal poisoning”)
The formation of pseudo tumors
Decreased range of motion and limited mobility
Pain

Patients who experience these complications deserve to have the manufacturer of their defective device pay for revision surgery. This is not all they deserve, though, and a warranty allowing for a no-cost revision procedure doesn’t go far enough. Victims whose lives are affected by defective medical products should also be compensated for time missed from work; for pain and suffering; for emotional distress and for any reduction they experience in their quality of life.

Bio:

Christy Rakoczy, a J.D. from the University of California, is a legal writer and advocate for consumer rights and patient safety. You can read more of her work on the Stryker hip implants, including recall information, complications, and ongoing legal action, at strykerhiprecall.co.

CIHI Study Reveals Problems with Metal-on-Metal Hip Implants (earlsview.com)

Filed under: Cobalt chrome, Cobalt Poisoning, Cobaltism, DePuy ASR Hip, DePuy Hip Litigation, Hip Replacement, Hip Revisions, Johnson & Johnson, Metal on metal hip, Stryker, Stryker ABGII Modular Femoral Stem, Stryker Hip Implant Recall, Stryker profits, Stryker rejuvenate hip, Stryker ShapeMatch, Stryker Trident Hip Recall, Stryker Trident Hip Replacement System, Suffering, Total Hip Replacement Tagged: Consumer Reports, DePuy, Hip Replacement, hip replacement products, India, joint replacement, knee replacement, Medical device, metallosis, Stryker Hip Replacements, surgery, University of California

J&J Knee Implant Settlement Approved by Australian Judge – Bloomberg

earlstevens58 — Tue, 04 Dec 2012 20:25:16 +0000

J&J Knee Implant Settlement Approved by Australian Judge – Bloomberg.

J&J Knee Implant Settlement Approved by Australian Judge

By Joe Schneider - Dec 4, 2012 10:00 AM ET

Johnson & Johnson (JNJ)’s settlement with Australian patients who received faulty knee implants was approved by a judge, clearing the way for compensation to be paid beginning at A$30,000 ($31,000) per user.

Pamela Casey, who had a total knee replacement in 2008, sued Johnson & Johnson and its DePuy International unit in 2010 on behalf of all patients who had received the DePuy LCS Duofix Femoral implant. The companies agreed to settle the lawsuit in August with Federal Court Justice Robert Buchanan approving the deal today.“There have been very few complaints among the more than 430 inquiries received regarding the proposed settlement,” Buchanan wrote in his reasons for approval. None of the complaints “provide a reason not to approve the settlement,” he said.

DePuy and New Brunswick, New Jersey-based Johnson & Johnson voluntarily recalled the knee implant in 2009 after reports of defects surfaced. Prior to the recall, 5,071 of the implants were used in Australia, the judge said.

Johnson & Johnson and Warsaw, Indiana-based DePuy agreed to pay A$30,000 to people who underwent revision to the knee implant and didn’t require additional surgical procedures. The payment rises to A$65,000 for people who required two or three other surgical procedures, following the revision surgery.

People who required more surgeries or had significant complications or injuries will be assessed on an individual basis, according to the settlement, negotiated by the class action law firm Maurice Blackburn, which represented the plaintiffs.

Johnson & Johnson and DePuy also face an Australian lawsuit over hip implants, which were also recalled in 2009.

In the U.S., Johnson & Johnson agreed in August to pay about $600,000 to resolve three cases in the first settlements of litigation over hip implants. The company faces about 8,000 lawsuits over hip implants in the U.S.

The case is Pamela Joan Casey v. DePuy International Ltd. ACD10/2010. Federal Court ofAustralia (Sydney).

To contact the reporter on this story: Joe Schneider in Sydney at jschneider5@bloomberg.net

J&J Knee Implant Settlement Approved by Australian Judge – Bloomberg (bloomberg.com)
US Drug Watchdog Now Urges All DePuy ASR And DePuy Pinnacle Hip Implant Recipients to Call Them for the Names of the Best Law Firms- Especially If They Are Senior Citizens (prweb.com)
Federal DePuy ASR Lawsuits Approach 6,000 Notes Rottenstein Law Group, LLP | equities.com (earlsview.com)
Best Attorney for DePuy Hip Implant Recall Lawsuit Announced: McDonaldWorley.com Listed Among U.S. Top Lawyers by Newsweek (prweb.com)
New Lawsuit on DePuy Pinnacle Hip Implant Severe Complications (prweb.com)
Facebook Agrees To Pay As Many As 2 Million Users $10 Each In Settlement (FB) (businessinsider.com)
Australia – Walking wounded: many unaware of faulty implants (earlsview.com)
Smith and Nephew Issues Failure Warning on Metal Hip Implant – Florida Mass Tort Attorneys, Lawyers | Searcy Mass Torts (earlsview.com)
Judge gives initial OK to revised Facebook privacy settlement (vineoflife.net)
Judge finds “no obvious deficiencies” in Facebook Sponsored Stories settlement offer (slashgear.com)

Filed under: Cobalt chrome, Cobalt Poisoning, Cobaltism, DePuy, DePuy ASR Hip, DePuy Hip Litigation, Hip Replacement, Hip Revisions, Johnson & Johnson, Knee Implants, Knee Replacement, Knee Replacement Recall, Knee revision, Metal on metal hip, Total Hip Replacement Tagged: Australia, DePuy, Federal Court of Australia, Johnson, knee replacement, lawsuit, Maurice Blackburn, New Brunswick New Jersey

Knee and hip surgery rates increase – Australian Ageing Agenda: Aged Care and Retirement Industry News and Issues

earlstevens58 — Fri, 05 Oct 2012 11:50:36 +0000

Knee and hip surgery rates increase – Australian Ageing Agenda: Aged Care and Retirement Industry News and Issues.

Knee and hip surgery rates increase

Published on Thu, 04/10/2012, 05:19:50

Knee Replacement XRay. Photo by Scott Thieman

By Yasmin Noone

A rapidly increasing number of Australians are taking to hip or knee replacement surgery to fix their arthritic pain and injury woes, with nationwide data recording a 60 per cent rise in surgery figures over the last 10 years.

According to the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) 2011/12 annual report, more than 85,000 Australians underwent hip or knee surgery last year, marking an additional 4.3 four per cent of cases in one year.

President of the Australian Orthopaedic Association (AOA), Dr Graham Mercer, said the marked increase in hip and knee replacements in Australia is a good news story, highlighting surgery success rates over time.

He said the survival rate for most hip and knee replacement devices has grown to 90 per cent over the last 10 years.

“[It’s a] remarkable achievement by world standards,” Mr Mercer said, commenting on a decade of surgical success.”

Physiotherapist, Jeremy Kestenberg, said the newly released figures are as expected.

“We know the procedures have improved remarkably – the quality of the procedures the have improved and the rehabilitation protocols have improved,” Mr Kestenberg, the director of Revita Health for Seniors, said.

“When you have all those improvements in one and have better anecdotal evidence for the people who have had the procedures, then you encourage more people to have these procedures.”

Mr Kestenberg believes knee or hip replacement surgery is often a lifeline for those older people suffering from severe arthritis or other pain, recovering from a fall, or having a hard time coping with their medications. But then again, he adds, so too is rehabilitation which aims to get the patient back to living their life, post-surgery.

“I guess overall, we want to look at outcomes. People are not going to look at surgery if they don’t need it.

“[We’ve found] that people who have been suffering from arthritis and severe pain for long periods of time often comment ‘it’s the best thing I’ve ever done’ after surgery. That’s a positive thing.”

Detailing all hip and knee replacements performed in Australia over the last 12 years, the annual report is thought to be one of the most comprehensive registries of its kind in the world.

It analysed 713,077 hip and knee replacement procedures in Australia since September 1999 - more than 332,350 hip and over 380,720 knee procedures.

It estimated that the median age of hip replacement for women is 73 years, and 68 years for men. Knee replacement figures also recognised that the median male age was 68 compared with 69 years for women.

“…People who have been suffering from arthritis and severe pain for long periods of time, often comment ‘it’s the best thing I’ve ever done’ after surgery. That’s a positive thing.” Jeremy Kestenberg

Australian women have had more hip replacements than men with 188,145 procedures for women and 144,206 for men. Equally women have had more knee replacements with 213,092 compared to 167,634 for men.

“With 12 years of data, trends can be seen with some significant patterns emerging,” Dr Mercer added.

“For example, more women are having replacement surgery, however men are having replacements earlier.”

The difference between male and female knee and hip replacement trends, according to Mr Kestenberg, may be due to physical work performed by men in what used to be known as ‘traditionally male roles’.

“Anecdotally, it can just be due to high physical workloads putting pressure on the joints in early life.”

Another trend to come out of last year is the increase in revision hip procedures, which increased from 4,013 or 11.3 per cent in 2010 to 4,646 or 12.5 per cent of all hip replacements during the reporting period.

PREVENTION OVER REPLACEMENT

Although Mr Kestenberg sees the great value that improved knee and hip replacement surgeries have on the quality of life of an older person, as a physiotherapist, he still recommends prevention rather than reactive solutions.

“We say that older people should really parent up with a physiotherapist for life,” he said.

“Overall good physical health, regular exercise, falls prevention programs and pain management programs can reduce the need to have surgery.

“So avoiding surgery is really about partnering up with a physio or health professional to help create a goal-driven preventive approach to [your health].

“It’s never too late to start. If you can delay or prevent that fall then why not?

Hip Replacement Found Safer for Women Than Resurfacing – Bloomberg (earlsview.com)
Variability in Costs Associated with Total Hip and Knee Replacement Implants (earlsview.com)
Alert issued for another hip implant – 04-Oct-2012 – NZ Health & Safety news (earlsview.com)
Hundreds of NZ hip replacements are faulty – National – NZ Herald News (earlsview.com)
UK – National Joint Registry 9th Annual Report 2012 (earlsview.com)
Hip resurfacing ‘not suitable’ for women – Health – Halifax Courier (earlsview.com)
NZ – Metal on Metal – Smith & Nephew – Medsafe hip device statement | Scoop News (earlsview.com)
Dr. Robert Armstrong Remarks on Efforts to Improve Hip and Knee Replacement Surgeries (prweb.com)
Smith & Nephew Withdraw THR version of BHR – Warning issued about hip implant (earlsview.com)
Knee implants: more evidence needed? (earlsview.com)

Filed under: Hip Replacement, hip surgery, Knee surgery Tagged: arthritis, Australia, australian orthopaedic association, Graham Mercer, Health, Hip Replacement, hip replacement surgery, knee replacement, knee replacement surgery, Medicine, NephewSmith, science, surgery

WOW!!! Biomet Announces Lifetime Limited Implant Replacement Warranty on Oxford(R) Partial Knee When Implanted with Signature(TM) Personalized Patient Care System – MarketWatch

earlstevens58 — Tue, 25 Sep 2012 20:21:15 +0000

Biomet Announces Lifetime Limited Implant Replacement Warranty on Oxford(R) Partial Knee When Implanted with Signature(TM) Personalized Patient Care System – MarketWatch.

PRESS RELEASE Sept. 24, 2012, 4:29 p.m. EDT

Biomet Announces Lifetime Limited Implant Replacement Warranty on Oxford(R) Partial Knee When Implanted with Signature(TM)* Personalized Patient Care System

WARSAW, Ind., Sep 24, 2012 (BUSINESS WIRE) — Biomet announced today a Lifetime Knee Implant Replacement warranty in the U.S., covering the Oxford(R) Partial Knee utilizing Signature(TM) technology. With the Lifetime Implant Replacement Warranty, Biomet will cover the cost of a Biomet replacement implant for U.S. patients who received the Oxford(R) Partial Knee implanted utilizing Signature(TM) technology and need revision surgery for any reason, subject to the terms and conditions of the written warranty. The warranty is effective for the replacement of Oxford(R) Partial Knees implanted utilizing Signature(TM) personalized positioning guides in the United States on or after September 10, 2012. Any additional costs associated with a replacement surgery beyond the Biomet replacement implant will not be covered by Biomet.

Biomet President and CEO Jeff Binder stated: “Since our founding 35 years ago, Biomet has established a heritage of offering innovative technologies and services that contribute to the delivery of high-quality, high-value personalized patient care. We believe that this is the only warranty of its type in the U.S., and we plan to assess the value of the program to our customers in a dynamically changing healthcare environment.”

The Lifetime Implant Warranty builds on the proven track record of the Oxford(R) Partial Knee. One published long-term clinical study on the Oxford(R) Partial Knee demonstrated a 91% survivorship at 20 years.(1)

Biomet’s Oxford(R) Partial Knee System is designed to help surgeons preserve and restore normal knee function and movement by replacing only the medial, diseased compartment of the knee. The Oxford(R) Partial Knee procedure removes approximately 75% less bone** than a total knee replacement and has been shown to allow for a more rapid recovery(2) when compared to a total knee replacement. The Signature(TM) Personalized Patient Care System complements the Oxford(R) Partial Knee by providing surgeons with a technique to perform knee replacement surgery specific to a patient’s anatomy.

Partial knee replacement is intended to preserve healthy knee structures in patients with limited knee arthritis by replacing only one side of the knee, and to provide more natural motion when compared to a total knee replacement.(3,4) Partial knee replacement may also provide for less pain(5) and shorter recovery periods(2) than total knee replacement.

Patient Risk Information

The Oxford(R) Partial Knee is intended for use in individuals with osteoarthritis or avascular necrosis limited to the medial compartment of the knee and is intended to be implanted with bone cement. The Oxford(R) Knee is not indicated for use in the lateral compartment. Potential risks include, but are not limited to, loosening, dislocation, fracture, wear and infection, any of which can require additional surgery. For additional information about the Signature(TM) system and the Oxford(R) Knee, including risks and warnings, talk to your surgeon and see the full patient risk information on http://oxfordknee.com .

About Biomet

Biomet, Inc. and its subsidiaries design, manufacture and market products used primarily by musculoskeletal medical specialists in both surgical and non-surgical therapy. Biomet’s product portfolio encompasses large joint reconstructive products, including orthopedic joint replacement devices, and bone cements and accessories; sports medicine, extremities and trauma products, including internal and external orthopedic fixation devices; spine and bone healing products, including spine hardware, spinal stimulation devices, and orthobiologics, as well as electrical bone growth stimulators and softgoods and bracing; dental reconstructive products; and other products, including microfixation products and autologous therapies. Headquartered in Warsaw, Indiana, Biomet and its subsidiaries currently distribute products in approximately 90 countries.

*A collaborative partnership with Materialise N.V.

**Biomet internal comparison of bone removal – Oxford(R) Knee compared to Vanguard(TM) Knee

REFERENCES

1. Price AJ, Svard U, A second decade lifetable survival analysis of the Oxford(R) unicompartmental knee arthroplasty. Clinical Orthopedics and Related Research 469(1):174-9, 2011.

2. Lombardi, A, et al., Is Recovery Faster for Mobile-bearing Unicompartmental than Total Knee Arthroplasty? Clinical Orthopedics and Related Research. 467:1450-57.2009.

3. Cobb, J, et al., Functional Assessment of knee arthroplasty using an instrumented treadmill. Imperial College of London. March 8, 2012 (presentation).

4. Price AJ, et al., Simultaneous in vitro measurement of patellofemoral kinematics and forces following Oxford medial unicompartmental knee replacement. JBJS(Br). 2006; 88-B; 12: 1591-1595.

5. Hall et al., Unicompartmental Knee Arthroplasty (Alias Uni-Knee)–An Overview with Nursing Implications. Orthopedic Nursing. 2004; 23(3): 163-171.

All trademarks herein are the property of Biomet, Inc., or its subsidiaries, unless otherwise indicated.

SOURCE: Biomet, Inc.

The case for partial knee replacement | Health & Fitness (earlsview.com)
Knee implants: more evidence needed? (earlsview.com)
Zimmer Knee Failure | Zimmer Knee Lawyer (earlsview.com)
Variability in Costs Associated with Total Hip and Knee Replacement Implants (earlsview.com)
Smith & Nephew launches new hinge knee implant (earlsview.com)
Spectrum Health Uses New Sensor To Optimize Knee Replacement (detroit.cbslocal.com)
YAHOO – Smith & Nephew Birmingham Hip Lawsuit Filed Over Metal Poisoning – AboutLawsuits.com (earlsview.com)
UK – National Joint Registry 9th Annual Report 2012 (earlsview.com)
‘Total knee replacement helps 37 year old Yashodhamma walk on her feet again after 4 years’ (earlsview.com)
No early link between all-metal hip implants and cancer-study | Reuters (earlsview.com)

Filed under: Biomet, Knee Replacement, Knee revision Tagged: Biomet, Health, Knee, knee replacement, Medicine, Oxford, patient care system, replacement warranty, Research, science, surgery, Unicompartmental knee arthroplasty, UNited States, Warranty

UK – Hospitals failing to comply with National Joint Registry submissions | Arthritis Research UK

earlstevens58 — Tue, 18 Sep 2012 11:45:49 +0000

Source: Hospitals failing to comply with National Joint Registry submissions | Arthritis Research UK.

Hospitals ‘failing to comply with National Joint Registry submissions’

Published on 14 September 2012

NHS trusts and health boards are now required to submit information to the National Joint Registry (NJR), but a study suggests many are failing to do so.

The registry was launched in 2002 and collects data on hip, knee, ankle, elbow and shoulder replacement procedures in order to highlight any issues of concern relating to patient safety.

Submissions to the registry – the largest of its type in the world – were made mandatory by the government in April 2011, but a new report indicates that many NHS organisations are risking patients‘ long-term safety by failing to comply.

Two-fifths of relevant NHS trusts and health boards were rated ‘red’ for submissions for 2011, which means that they submitted data on less than 80 per cent of the hip and knee replacement operations performed that year.

Elaine Young, national development lead for the NJR, said that these data are “essential” for healthcare professionals, as they help them to decide which prostheses and procedures are safest for individual patients.

“The fuller the picture provided by hospitals, the more robust the data quality, which can only lead to further improvements in patient care,” she explained.

Ms Young said that the situation has improved, but emphasised that cases where English trusts and Welsh health boards fail to comply will be escalated to the relevant regulators in future.

Professor Paul Gregg, vice-chair of the NJR Steering Committee and chair of its surgeon outlier sub-committee, commented: “The NJR relies on hospitals to help maximise data quality – it is therefore highly disappointing that not all trusts and health boards are currently registering all operations, as this will have a negative effect on this process.”

A spokesman for Arthritis Research UK echoed Professor Gregg’s comments.

“The NJR can only do its job if hospital trusts co-operate in supplying it with the relevant information. This is particularly important given the ongoing situation with metal-on-metal hip replacements,” he added.

All-metal hips ‘wear down faster’ – Health – Warwick Courier (earlsview.com)
Knee implants: more evidence needed? (earlsview.com)
No cancer rise in hip implant patients – Behind The Headlines – Rutland and Stamford Mercury (earlsview.com)
New research uses stem cells as possible treatment for arthritis | CTVNews (earlsview.com)
Patients with metal-on-metal hips being contacted after UK officials issue alert | Orthopedics Today (earlsview.com)
No early link between all-metal hip implants and cancer-study | Reuters (earlsview.com)
Failure rates of stemmed metal-on-metal hip replacements : The Lancet (earlsview.com)
Patient undergoes four joint replacement surgeries – Times Of India (earlsview.com)
Interview with Derek McMinn and Ronan Treacy – Orthopaedic Product News (earlsview.com)
No cancer rise in hip implant patients – Health – Fleetwood Weekly News (earlsview.com)

Filed under: National Joint Register Tagged: Health, Hip Replacement, knee replacement, Medicine, National Joint Registry, NHS, nhs organisations, nhs trusts, NJR, Patient, Paul Gregg, Research, science

Relief Tips for Joints Besieged by Osteoarthritis – NYTimes.com

earlstevens58 — Sat, 01 Sep 2012 08:07:58 +0000

Relief Tips for Joints Besieged by Osteoarthritis – NYTimes.com.

JULY 9, 2012, 12:01 AM

Relief for Joints Besieged by Arthritis

By JANE E. BRODY

If you live long enough — that is, beyond 50 or 60 — chances are one or more of your joints, probably your knees or hips, will become arthritic. And if pain or stiffness begin to seriously limit your ability to enjoy life and perform routine tasks, chances are you’ll consider replacing the troublesome joint.

Between 1979 and 2002, knee replacement surgery rose 800 percent among people 65 and older. Although Dr. Felson described hip replacement as “dynamite” — highly effective in relieving pain and restoring function — knee replacement may be far less helpful.

“For 10 to 30 percent of patients, the improvement never comes,” Dr. Felson said.

How the Trouble Starts

Osteoarthritis results from wear and tear on the joints. (Rheumatoid arthritis, on the other hand, is an autoimmune disorder.) Some 27 million Americans have life-limiting osteoarthritis, and the numbers are rising as the population gets older and fatter.

“With every step, the force exerted on weight-bearing joints is one and a half times body weight,” said Dr. Glen Johnson, who reported on arthritis prevention and treatment at the annual meeting of the National Athletic Trainers’ Association in June. “With jogging, the force is increased seven or eight times. Thus, the most effective way to prevent arthritis in knees and hips is to lose weight if you’re overweight and to pursue non-impact activities for recreation.”

While most people think of osteoarthritis as a breakdown of the cartilage that keeps bones from rubbing together, recent studies have shown it is a far more complicated disease that also involves tissues in and around joints, including bone and marrow. Inflammation can be a contributing factor, and genetics play a role. Three genes have been identified thus far that accelerate the development of arthritis in people who carry them.

Any kind of joint injury or surgery, even if performed arthroscopically, raises the risk that a joint will become arthritic. That is why so many professional and recreational athletes develop arthritis at younger ages.

Still, there are many potential remedies short of surgery to relieve arthritic pain and to preserve — and perhaps restore — normal joint function. Even if surgery is needed, it can be postponed for many years with treatments proven to help in well-designed clinical trials.

Artificial joints usually last 10 to 15 years. Delaying surgery is helpful because the earlier in life a joint is replaced, the more likely a subsequent replacement will be needed. And both devices and surgical techniques are constantly being improved; by delaying a joint replacement, you may end up with a simpler operation or more durable device.

Take it from someone who has been there: Joint replacement, especially of the knee, is not a walk in the park. Arduous physical therapy is essential, and recovery can be long and painful. There are limitations after recovery, too, because artificial joints are not as flexible as the ones you were born with.

What Works, What Doesn’t

First things first: If you weigh more than you should, do your best to shed those extra pounds. Even a loss of 10 to 15 percent of body weight can make a big difference to weight-bearing joints.

“I can’t stress enough how important body weight is,” Dr. Johnson said. “With our national crisis of obesity, we’ll see more and more arthritis of the knees, ankles, hips and spine.”

Stephen Messier, a professor of health and exercise science at Wake Forest University, has shown in a trial among 450 men and women with osteoarthritis that a weight-loss diet combined with a well-designed exercise program can significantly reduce knee pain.

The most helpful exercises are those that strengthen the quadriceps (muscles in the front of the thighs), like leg presses, mini-squats and wall squats, and flexion and extension exercises that restore and preserve range of motion, Dr. Johnson said. Several visits to a physical therapist can help assure that you are doing the exercises correctly.

“The severity of pain is directly correlated with the degree of muscle weakness,” Dr. Felson wrote in The New England Journal of Medicine. (If the knee hurts during exercise, he added, then it should be avoided.)

Wearing the right shoes with certain adjustments to the sole and heel, if needed, can help too. Get fitted in a store with expertise in evaluating feet and gait. Are your arches flat? Are you bow-legged or knock-kneed? Wedges specifically designed for you can help take stress off arthritic knees and hips.

Though most experts endorse walking for exercise for its ease, accessibility and low cost, Dr. Johnson instead recommends such non-impact activities as stationary or outdoor cycling, swimming, or working out on an elliptical or rowing machine for cardiovascular fitness. Those who choose to walk, he said, may benefit from runners’ shoes designed to dissipate the force on joints.

Bracing an arthritic knee can help, too, especially with an unloader brace that shifts the stress away from the damaged part of the joint. Most patients are unlikely to wear such a brace all the time, Dr. Felson said. Still, knee braces can help arthritis sufferers continue to participate in physical activities, reduce the use of pain medication and postpone the need for surgery.

Pain relievers usually bring only temporary relief, if any. Daily dosing with acetaminophen (the ingredient in Tylenol) should be tried first, experts say, because it is significantly safer than ibuprofen and other nonsteroidal anti-inflammatory drugs, especially for older people.

Well-designed clinical studies have shown no significant relief of arthritic knee pain from supplements of glucosamine and chondroitin sulfate, taken alone or in combination, though Dr. Felson said that if people feel better taking them, he does not discourage the practice.

Nor is there good evidence of benefit from methylsulfonylmethane, SAM-e or acupuncture. Some evidence suggests that osteoporosis drugs may be helpful, though they have not yet been tested for arthritis relief in a randomized clinical trial, Dr. Felson said.

There are also hints of benefit from vitamin K, an essential nutrient found in cruciferous vegetables (broccoli, kale, cabbage and the like), which are good for health in general (unless you take blood thinners).

Doctor-administered treatments include steroid injections every three or four months to control pain and buy time, and injections of a synovial fluid replacement like Synvisc twice a year. In general, though, these are not very effective when arthritis has reached the bone-on-bone stage, Dr. Johnson said.

Evidence to Support the National Action Plan for Osteoarthritis, Rheumatoid Arthritis and Osteoporosis: (earlsview.com)
New Technique Reduces Hip Pain Osteoarthritis & The Need For Hip Replacements | Splash Press Release (earlsview.com)
Knee implants: more evidence needed? (earlsview.com)
Well: Relief Tips for Joints Besieged by Osteoarthritis (well.blogs.nytimes.com)
Gene findings raise arthritis hopes – Eight new genes for osteoarthritis (earlsview.com)
Osteoarthritis depressed mood | Arthritis Research UK (earlsview.com)
Clinical depression can exacerbate Knee osteoarthritis symptoms in elder patients (earlsview.com)
Depression and Osteoarthritis – A Guide to Depression and Osteoarthritis (earlsview.com)
‘Total knee replacement helps 37 year old Yashodhamma walk on her feet again after 4 years’ (earlsview.com)
Osteoarthritis and Depression | Osteoarthritis Blog (earlsview.com)

Filed under: Arthritis, Osteoarthritis, Osteoarthritis Pain Tagged: arthritis, arthritis prevention, athletic trainers association, Felson, Health, Hip Replacement, Joint, Knee, knee replacement, knee replacement surgery, Medicine, national athletic trainers association, osteoarthritis, Rheumatoid Arthritis

‘Total knee replacement helps 37 year old Yashodhamma walk on her feet again after 4 years’

earlstevens58 — Fri, 31 Aug 2012 23:20:35 +0000

‘Total knee replacement helps 37 year old Yashodhamma walk on her feet again after 4 years’.

Bangalore: A team of experts led by Dr. Alwin Almeida, Consultant, Orthopedic and Joint Replacement Surgeon, Fortis Hospitals Nagarbhavi, Bangalore performed a complex Total Knee Replacement Surgery on a 37year old Yashodhamma from Sharavanabelagola who was suffering from Rheumatoid arthritis for the past 18 years with no significant measures to control the disease. Rheumatoid arthritis had severely crippled her Right Knee and Right Elbow joints. She suffered severe pain and had not walked for the last 4 years. She tried various therapies and medicines, but couldn’t get rid of her problem. She was confined to her bed and had lost hope in life.

Learning about the benefits of total knee replacement described by Dr. Alwin in a local television channel, Yashodhamma’s family decided to visit Fortis Hospitals in Nagarbhavi. Yashodamma came with the hope of getting rid of the pain and getting back to her feet. Post Examination Dr. Alwin found out that the reason for her crippled leg and severe pain was due to a badly deformed Right Knee with 45 degrees of Knee bending, 30 degree inward bowing of the leg and extensive bone loss. She was planned for a total knee replacement surgery on the Right Knee.

Commenting on the Surgery Dr. Alwin Almeida said, ‘’the surgery was technically demanding and needed meticulous planning. The deformity in multiple planes had to be corrected and the loss of bone had to be addressed. The surgery required an extensive release of contracted muscles and soft tissue and clearing up of hardened and deformed bones. The deformities were fully corrected by meticulous surgical correction. The plan was to use a wedge metal implant or bone graft to overcome the bone defect as there was a large bone loss on the inner part of the leg bone. However during the surgery we were able to manage the bone defect using bone cement and primary implant alone with extension stem. This helped us in preserving much of the patient’s original bone.’’

Yashodhamma was made to walk the very next day of the surgery. First time in 4 years she kept her right foot on the floor which made her feel like God has given her a rebirth, ending her years of crippling pain and trauma. Presently Yashodhamma is comfortable with knee in straight alignment, no deformities and has good range of movements (0 to 120 degrees). Most importantly she has walked for the first time in 4 years. She is now able to perform all household activities and is active in her social life.

Mr. Harish Manian, Facility Director, Fortis Hospitals, Nagarbhavi said, “We at Fortis Hospitals are committed to create a world class healthcare delivery system with the best clinical outcome. The Hospital over the last couple of years have become a center of excellence for all kinds of Orthopaedic work like, Joint Replacement, Arthroscopy, Trauma management etc. Our Orthopaedic team in Fortis Hospitals, Nagarbhavi headed by Dr. Alwin has delivered world class clinical outcomes in Joint replacement surgery and Trauma management, which has resulted in patients coming not only from Bangalore & other districts of Karnataka, but also from Tamilnadu and Andhra Pradesh.’’

‘’ I am thankful to Dr. Alwin and Fortis Hospitals for giving me a second life. When I came to the hospital I was brought in a stretcher and I went back walking when I got discharged. My 18 years of pain and trauma has come to an end and now I am doing all those things like attending weddings, going to temple and all other activities which I couldn’t do all these years’’ said an elated Yashodhamma.

Variability in Costs Associated with Total Hip and Knee Replacement Implants (earlsview.com)
The case for partial knee replacement | Health & Fitness (earlsview.com)
Patient undergoes four joint replacement surgeries – Times Of India (earlsview.com)
Knee implants: more evidence needed? (earlsview.com)
Joint Replacements For Baby Boomers (earlsview.com)
Zimmer Knee Failure | Zimmer Knee Lawyer (earlsview.com)
CSU-developed implant shows promise (earlsview.com)
Post-Op: My Seventh Month in Recovery after a Total Knee Replacement (topofthebellcurve.typepad.com)
Orthopedics device startup wants to win share by providing customized knee implants (medcitynews.com)
What Is Knee Replacement Surgery? What Is Knee Arthroplasty? (medicalnewstoday.com)

Filed under: Joint replacement, Knee Implants, knee injury, Knee Pain, Knee Replacement Tagged: Alwin, Andhra Pradesh, Bangalore, bone graft, elbow joints, Health, joint replacement, knee replacement, knee replacement surgery, Medicine, Orthopedic, Rheumatoid Arthritis, surgery, total knee replacement surgery

LINKÖPING, Sweden: Sectra initiates cooperation with Zimmer for orthopaedic surgery

earlstevens58 — Fri, 31 Aug 2012 22:13:41 +0000

LINKÖPING, Sweden: Sectra initiates cooperation with Zimmer for orthopaedic surgery | Business Wire | Rock Hill Herald Online.

Sectra initiates cooperation with Zimmer for orthopaedic surgery

Published: August 31, 2012

LINKÖPING, SWEDEN — IT and medical imaging company Sectra (http://www.sectra.com/medical/) (NASDAQ OMX: SECT B) and Zimmer GmbH, a global leader in musculoskeletal care, have signed a non-exclusive cooperation agreement. This will allow Zimmer to provide its customers in certain European countries with Sectra’s online 2D pre-operative planning system for orthopaedic surgery.

“Through cooperation with partners with an extensive network and high market presence, Sectra anticipates expanding its orthopaedic business further,” says Hanna Eriksson, General Manager of Sectra’s orthopaedic operations.

The agreement is an important step in Sectra’s strategy for expanding its online services offering, but is expected to have limited financial impact on Sectra’s medical operation for the current fiscal year.

Sectra is a market leader in orthopaedic planning. Sectra’s digital planning tools can be used to plan both joint reconstruction and trauma surgery. The online service functions, regardless of the customer’s PACS supplier and the pre-operative planning tools, can improve quality of care by increasing pre-operative planning accuracy, thus reducing risks of postoperative complications.

The Sectra online service, Sectra Preop Online, provides high-precision digital templating tools to surgeons that allow them to digitally plan their joint replacement surgeries for an optimal surgical outcome. With digital templating, orthopaedic surgeons can create a consistent and well-documented workflow, increase accuracy when planning implant sizes and alignments, plan for different scenarios beforehand and ensure that the right implants are always available.

More than 151 million people worldwide suffer from osteoarthritis, the most common cause of hip and knee replacement surgery. In 2011, about three million hip and knee replacement procedures were performed globally[1] (http://#_ftn1), a figure that is expected to rise with an aging population and lifestyle changes.

[1] (http://#_ftnref1) https://www.orthoworld.com/

About Sectra

Sectra develops and sells IT systems and services for radiology, women’s health, orthopaedics and rheumatology. More than 1,400 hospitals, clinics and imaging centers worldwide use the systems daily, together performing over 55 million radiology examinations annually. This makes Sectra one of the world-leading companies within systems for handling digital radiology images. In Scandinavia, Sectra is the market leader with more than 50% of all film-free installations. Sectra’s systems have been installed in North America, Scandinavia and most major countries in Europe and the Far East.

Sectra was founded in 1978 and has its roots in Linköping University in Sweden. The company’s business operation includes cutting-edge products and services within the niche segments of medical systems and secure communication systems. Sectra has offices in 12 countries and operates through partners worldwide. Sales in the 2011/2012 fiscal year totaled SEK 823 million. The Sectra share is quoted on the NASDAQ OMX Stockholm AB exchange. For more information, visit http://www.sectra.com

This information was brought to you by Cision http://www.cisionwire.com

Hip damages claim rejected – Irish Medical Times (earlsview.com)
Variability in Costs Associated with Total Hip and Knee Replacement Implants (earlsview.com)
‘Toxic’ hip replacement fears – Health – Belfast Newsletter (earlsview.com)
New Surgical Approach Allows for Outpatient Total Hip Replacement (earlsview.com)
Emotions Can Affect Recovery From Hip Surgery (earlsview.com)
Minimally Invasive Total Hip Replacement Speeds Recovery – Yahoo! News (earlsview.com)
Australia – ABGII Modular Femoral Stem and Modular Neck – hip replacement system (earlsview.com)
‘Toxic’ hip replacement fears – Health – Bognor Regis Observer (earlsview.com)
Knee implants: more evidence needed? (earlsview.com)
Digital pathology receives support from Vinnova (Sweden’s Innovation Agency) (tissuepathology.com)

Filed under: Hip Replacement, Zimmer Tagged: Health, Hip Replacement, joint reconstruction, knee replacement, LINKÖPING, Linköping University, Orthopedic surgery, replacement surgeries, Research, science, sectra, surgery, Sweden

The case for partial knee replacement | Health & Fitness

earlstevens58 — Thu, 23 Aug 2012 11:02:32 +0000

The case for partial knee replacement | Health & Fitness.

The case for partial knee replacement

Tuesday, August 07, 2012 12:45 pm
Staff Reports

The knee is composed of three separate compartments. Osteoarthritis often develops in only one compartment of the knee, while the other two compartments remain relatively healthy. Patients who have osteoarthritis in only one compartment, the inner side, may be candidates for partial knee replacement.

The Oxford partial knee implant from Biomet Orthopedics is a partial knee implant designed to repair only one side of the knee – the medial side – making it much smaller than a total knee implant. Unlike total knee replacement, which removes all of the knee joint surfaces, a partial knee replacement replaces only one side of the knee joint.

Some advantages of the Oxford partial knee replacement are that it removes 75 percent less bone and cartilage, is less painful, enables a more rapid recovery, and provides more natural motion when compared to a total knee replacement. By retaining all of the undamaged parts, the joint may bend and function more naturally.

Unlike other implants, the Oxford partial knee is currently the only fully mobile bearing partial knee system available in the United States. Research has shown that partial knee replacements with moveable plastic bearings have low wear rates, potentially giving them even longer life expectancies. The free floating nature of the device potentially provides for a more natural feeling knee.

There is no guarantee that any implant will successfully function for a specific length of time, as there are a multitude of variables that affect the life of an implant. But those who have been told they need a total knee replacement may be a candidate for a partial replacement.

Submitted by Dr. George C. Alber at Shore Orthopedic University Associates. To see what your treatment options are for your arthritic knee, call to schedule a consultation at (609) 927-1991.

Knee implants: more evidence needed? (earlsview.com)
Variability in Costs Associated with Total Hip and Knee Replacement Implants (earlsview.com)
My tailor-made knee | Health | Express.co.uk (earlsview.com)
Zimmer Knee Failure | Zimmer Knee Lawyer (earlsview.com)
CSU-developed implant shows promise (earlsview.com)
Joint Replacements For Baby Boomers (earlsview.com)
What Is Knee Replacement Surgery? What Is Knee Arthroplasty? (medicalnewstoday.com)
New research uses stem cells as possible treatment for arthritis | CTVNews (earlsview.com)
Orthopedics device startup wants to win share by providing customized knee implants (medcitynews.com)
All-metal hips ‘wear down faster’ – Health – Warwick Courier (earlsview.com)

Filed under: Knee Replacement Tagged: Health, Implant (medicine), Knee, knee replacement, Medicine, orthopedic university, Oxford, oxford partial knee replacement, partial knee replacement, partial knee replacements, plastic bearings, Unicompartmental knee arthroplasty, UNited States, united states research

Knee implants: more evidence needed?

earlstevens58 — Wed, 22 Aug 2012 11:34:00 +0000

Knee implants: more evidence needed? – Health – Belfast Newsletter.

Knee implants: more evidence needed?

Published on Wednesday 22 August 2012 12:28

The effectiveness of knee replacement surgery was in the news today, when the BBC and Independent reported that more evidence was needed on the long-term safety of knee implants.

The news, which follows recent reports on the safety of PIP breast implants and certain metal hip implants, is based on a report on knee replacement surgery published in The Lancet medical journal. It argued that although knee replacement surgery is highly successful as a treatment for osteoarthritis, there is a need for more long-term monitoring of surgery outcomes and steps to ensure that patients selected for surgery are suitable.

In addition, the report’s authors say that new implant designs are continually being introduced, often with little or no evidence of their effectiveness, and that more long-term monitoring of their safety and effectiveness is needed.

Although some online news sources have suggested that the review article found knee replacement to be dangerous, this is misleading. The report says that knee replacement is generally successful but that more needs to be done to assess which patients will benefit, to collect data on outcomes and to carefully monitor the introduction of new implant designs.

Why are knee replacements performed?

Knee replacements are usually carried out when the knee has been damaged by arthritis. In most cases, surgery is for osteoarthritis, the most common form of this disease, although it is also used for other forms. In osteoarthritis, the parts of the knee that slide over each other as you move become damaged, through either gradual wear or an injury. Only a small number of people with arthritis in the knees are given knee replacement surgery. It is usually considered if someone is in persistent, disabling pain and if non-surgical treatments, such as physiotherapy, have not helped.

During the operation, the surfaces of the knee joint that have been damaged by arthritis are removed and replaced by new parts, made of metal and plastic. In effect, this artificial hinge replicates the natural range of movements of the knee. Patients can have either a total knee replacement (TKR), in which all the surfaces are replaced, or a partial knee replacement, in which only part of the knee is replaced. A TKR is the most common form of the operation.

How many people in the UK have an implant?

Knee replacement surgery is an increasingly common procedure and the number of operations is rising annually. Over 70,000 knee replacement operations are carried out each year, about four out of five of them in women. In the UK, rates of knee replacement operations in women increased from 43 per 100,000 person years in 1991 to 137 per 100,000 person years in 2006.

The average age for having this surgery is 70 years old but, according to the new report, knee replacement is increasingly being considered for patients younger than 55. The authors say that the reason for this trend is unclear. For example, it could be due to increased patient expectation or more osteoarthritis among young people because of the increasing incidence of obesity.

Are knee replacements effective?

Knee replacement surgery is generally considered to be a highly successful operation. It improves pain, mobility and quality of life in many people with advanced arthritis of the knee joint. The charity Arthritis Research says that about four out of five people who’ve had the operation say they are happy with their new knees. However, some people are disappointed with the outcome of their surgery or are unsure whether there has been an improvement.

This is why it’s important to ensure that patients considered for the operation are those who would derive the most benefit. The National Institute for Health and Clinical Excellence (NICE) says that although joint replacement operations can provide very good pain relief for many people with osteoarthritis, in a substantial number of cases the outcome is not good enough. “It would be very useful to have pre-operative tools to help choose the people who would derive most benefit,” NICE commented.

The new review article argues that there’s an urgent need for improved decision making to assess whether a patient should undergo the procedure. Evidence-based information should be given to patients about factors that are known to influence the outcome of their surgery.

The article also says that long-term monitoring of outcomes is needed, through national joint-replacement registries and electronic patient records reporting the rates of revision surgery and other outcomes.

Are knee replacements safe?

All major operations carry some immediate risks, including blood clots and infection. In the longer term, knee replacement surgery can lead to complications. These include the knee giving way (instability) or continuing to hurt, numbness around the joint, problems with bending and the need for a second operation to correct or remove part of the implant, known as revision surgery. The need for revision surgery is often the result of the new joint becoming loose. Other common reasons include infection, pain and stiffness.

Some internet news reports implied that the review has judged knee replacements to be unsafe. However, the article primarily discussed the decision-making processes behind knee replacement surgery and the need to gather evidence on the best practice for knee replacement and on the effectiveness of new implant designs. It did not suggest that knee replacement is unsafe or that it should be stopped, although it did argue for improved collection of safety data.

What does the report say about implant design?

The report says that orthopaedic manufacturers are continually introducing new designs for implants and that doctors expect that these new implants will improve outcomes. However, there is evidence to suggest “this belief is incorrect”. The new implants are often introduced with little or no evidence of their effectiveness, the report adds.

Limited release of new implant designs as part of well-conducted large-scale randomised controlled trials is essential, the authors argue. In addition, national joint registries should monitor the outcomes of new implant designs.

How are knee replacements tracked?

The report says that national joint replacement registries, such as the UK’s National Joint Registry (NJR), are one of the best and most important sources of data on knee replacement surgery. These registries collect data on measures such as revision surgery, as well as patient-reported outcomes.

According to the report, improved long-term monitoring of outcomes using both national registries and electronic patient records should be undertaken. This is so that both patients and surgeons have good-quality evidence to assess different implants and techniques and to improve decision making.

The Medicines and Healthcare products Regulatory Agency has reportedly said that since April 2003, all knee joint replacement operations in England and Wales have been recorded by the NJR.

Who should I speak to if I’m worried about my implant?

If your implant is causing problems or you are anxious about it, ask your GP to refer you to your surgeon.

All-metal hips ‘wear down faster’ – Health – Warwick Courier (earlsview.com)
Variability in Costs Associated with Total Hip and Knee Replacement Implants (earlsview.com)
My tailor-made knee | Health | Express.co.uk (earlsview.com)
‘Toxic’ hip replacement fears – Health – Belfast Newsletter (earlsview.com)
Zimmer Knee Failure | Zimmer Knee Lawyer (earlsview.com)
New research uses stem cells as possible treatment for arthritis | CTVNews (earlsview.com)
Clinical depression can exacerbate Knee osteoarthritis symptoms in elder patients (earlsview.com)
Joint Replacements For Baby Boomers (earlsview.com)
CSU-developed implant shows promise (earlsview.com)
Patient undergoes four joint replacement surgeries – Times Of India (earlsview.com)

Filed under: Knee Implants, knee injury, Knee Pain, Knee Replacement Tagged: arthritis in the knees, BBC, Health, Hip Replacement, Knee, knee replacement, knee replacement surgery, Lancet, Medicine, osteoarthritis, science, surgery, The News Letter

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