The Facts of Hip Replacement
The idea of using implants to surgically repair injured or worn joints dates back three centuries. Since the 1970s, modern hip implants restored mobility and quality of life to a number of people. Thanks to modern medicine, many people are living longer lives. Because of this, many hip implant manufacturers like DePuy endeavored to create more durable implants that would provide longer, more efficient performance for younger, active patients.
In 2005, Johnson & Johnson’s DePuy unit released the ASR line of metal-on-metal (MoM) implants that promised increased performance, decreased risk of dislocation and wider range of motion. The devices were popular, and doctors implanted 93,000 of these devices worldwide before they were recalled in 2010.
The recall came too late for thousands of people who suffered complications from the ASR.
Complications from DePuy Hip Implants
Normally, hip implants last about 15 years, but some DePuy hips failed within a year of implantation. The same metal-on-metal design that was supposed to make the hip more durable resulted in painful complications for hundreds of people. Company documents revealed that nearly half of all DePuy ASR implants could fail early and require complicated and painful revision surgery to replace the implant.
The ASR implants use cobalt chromium shells, and all components are made of metal. When these metal parts rub against each other, metal particles flake off and seep into blood and tissue.
Critics say part of the problem is that the Food and Drug Administration (FDA) approved the DePuy ASR devices though the 510(k) approval process. This means that the government did not require testing before DePuy began selling the implants.
The FDA received almost 18,000 reports of problems with metal-on-metal implants like the ASR from 2000 to 2011. Patients filed lawsuits against DePuy after suffering from severe pain, tissue damage and metallosis – or metal poisoning.
Some of the complications reported include:
- Groin pain
- Tissue inflammation
- Pockets of fluid called pseudotumors
- Tissue discoloration
- Tissue death
- Implant loosening
In addition, the metal particles can travel to other organs and cause damage.
Alternatives to Hip Replacement Surgery
Most doctors recommend hip replacement surgery to people who suffer from osteoarthritis–a degenerative joint disease. For some people who are concerned about hip replacement surgery, there may be alternatives to delay or avoid it by treating the symptoms of osteoarthritis.
Some of these alternatives include:
- Keeping a Healthy Weight. People who are heavier put more stress on their joints and may wear them out quicker. Losing even just a small amount of weight can decrease pressure on joints.
- Chiropractic Care. Some clinical studies suggest that chiropractic care can treat the symptoms of osteoarthritis by increasing range of motion, restoring natural movement of the spine, reducing pain and relaxing the muscles.
- Nutrition. Certain foods can aggravate the inflammation around joints and make them less mobile and painful. Certain foods like garlic, onions, leafy greens and those rich in Omega-3 fatty acids have been shown to reduce inflammation.
- Supplements. Supplements may also help with joint pain. While many people have heard of glucosamine and chondroitin, study results on this supplement remain mixed for people with osteoarthritis. SAMe (s-adenosyl-L-methionine), on the other hand, is a lesser known supplement that studies show is as effective as Celebrex in reducing pain and improving joint function. This supplement may interfere with certain medications and should only be taken with doctor supervision.
For people who received a DePuy ASR or other metal-on-metal hip implant, the FDA recommends having regular follow-ups with their doctor even if there are no symptoms. If pain is an issue, doctors can use imaging studies and blood tests to check for metal levels and tissue damage.
Bio: Michelle Y. Llamas is a published writer and researcher. She hosts Drugwatch Radio, a health podcast, and writes about drugs and medical devices for Drugwatch.com.
University of Maryland Medical Center. (2011). Osteoarthritis. Retrieved from http://www.umm.edu/altmed/articles/osteoarthritis-000118.htm
Stanton, T. (2012, May). Metal-on-metal hip implants: The clinical issues. American Academy of Orthopaedic Surgeons. Retrieved from http://www.aaos.org/news/aaosnow/may12/clinical4.asp