Alarming Article in The New York Times - Metal-on-Metal Hip Replacement

[GwanJangNimETS]

While BHR and Smith & Nephew, Inc. are not implicated, The New York Times article gave me pause. Does anyone have more information about the devices mentioned in the article? Is there cause for concern?

This site will not allow me to post the link, so you will have to look it up yourself:


"Hip Implant Complaints Surge, Even as the Dangers are Studied"
The New York Times
August 22, 2011
By Barry Meier and Janet Roberts

[FlbrkMike]

Here is some discussion of the article you're referring to:

http://surfacehippy.info/hiptalk/index.php?topic=2675.msg20765#msg20765

[Denver_wrench]

I feel the article was pretty amatuerish. That said, metal ion issues are a reality. My own doctor feels that if the hip is asymptomatic he would leave it alone. I think other doctors have different opinions about when they would intervene. Personally, I educated myself and decide that the known risks did not outweigh the benefits. At the end of the day, the decision is up to the patient, and well-informed patients make better decisions.

[JMS]

Re your surgeon's belief that an asymptomatic hip can be left alone, I think we need to consider what we mean by asymptomatic.  For many people this means pain free, and functioning well, but hips that meet this criteria can still be problematic. I wouldn't suggest for a moment that people have MOM hips removed if there are no warning signs, but I think the challenge comes when an otherwise asymptomatic hip is linked to high ion levels.  How high do we let ion levels go before intervention?  Once the levels start to climb they can increase very rapidly.  In my case, the already sky high levels increased by approx 50% in the six week gap between the first test (16 months after surgery) and the second. 

[markm]

I personally don't think this is a fair representation of the facts. Any type of reconstructive surgery will have issues. Add to that, the rush of patients and surgeons in the last few years to have/perform resurfacing surgery. What are the relative facts compared to these increases. Not long ago, traveling out of country was the only option to get a resurfacing procedure. I wonder if the increase in failures has any relationship to this.

When depuy pulled the ASR off the market, they purchased Finsbury and the Adept system to replace it. Business as usual. My surgery was performed by Dr. Antoniou in Montreal. His record of success is extremely high with the ASR system. So is it the product or the surgeon.

Make no mistake, there is nothing better than an natural hip. When it fails, a man made replacement is no match in performance. Quality of life is improved, but there are risks. I decided to take it. This article just makes it easier for the legal firms looking for clients.

My heart pains for the lady featured in the article that this procedure did not work for her.

[obxpelican]

What you're going to find if you dig deep enough is that when a surgeon who does not have experience doing HRs you will find misaligned devices that can lead to many issues.  One is the metal ion issue.  If the surgeon does not get the angles correct the two parts of the device will not work smoothly and you end up with ions of the metal being shed, you then end up with pseudotumors.

I know of doctors who NEVER had issues with the ASR because they got the angles exactly right, the ASR has a tolerance issue whereby the surgeon must get the angle within a closer tolerance than other devices.

Once again this is why those of us who have seen the many issues from inexperienced surgeons always say it over and over, find yourself a doctor with lots of years and surgeries behind him/her.   Yes, you might feel good right after the surgery only to find out down the road a few years pain from inflamation and the resulting revision to a total hip.

Is there an issue with metal ions from metal on metal implants, heck yes!  Will you have an issue on a properly implanted device, probably not.

Once again everyone, if you are searching for a doctor to do your HR, look for experience and a good record, not just 100 surgeries over a few years, go for the most experienced doctor you can find.

One question you can ask your surgeon, ask him/her what they consider to be the optimal angle of the implant they use and ask them how many implants they placed incorrectly, if they give you the deer in the headlight stare, run, don't walk out.

Chuck

While BHR and Smith & Nephew, Inc. are not implicated, The New York Times article gave me pause. Does anyone have more information about the devices mentioned in the article? Is there cause for concern?

[phillwad]

I spoke with my the PA to my Doctor this week about this article - he let me know if is not new information and the risks we have discussed are real (as explained frequently on the site) and it was me that made to choice - compared to to the path I was on - struggling to go up steps, limping almost all the time etc etc

Cheers - Phill

[cwg]

Phil I agree with you and your doctor and am seriously glad it is working out for you.
I made the choice too and am regretting it deeply

I did not have all this information given to me in 2007

Have a blast running up the stairs now!

[Dannywayoflife]

What you're going to find if you dig deep enough is that when a surgeon who does not have experience doing HRs you will find misaligned devices that can lead to many issues.  One is the metal ion issue.  If the surgeon does not get the angles correct the two parts of the device will not work smoothly and you end up with ions of the metal being shed, you then end up with pseudotumors.

I know of doctors who NEVER had issues with the ASR because they got the angles exactly right, the ASR has a tolerance issue whereby the surgeon must get the angle within a closer tolerance than other devices.

Once again this is why those of us who have seen the many issues from inexperienced surgeons always say it over and over, find yourself a doctor with lots of years and surgeries behind him/her.   Yes, you might feel good right after the surgery only to find out down the road a few years pain from inflamation and the resulting revision to a total hip.

Is there an issue with metal ions from metal on metal implants, heck yes!  Will you have an issue on a properly implanted device, probably not.

Once again everyone, if you are searching for a doctor to do your HR, look for experience and a good record, not just 100 surgeries over a few years, go for the most experienced doctor you can find.

One question you can ask your surgeon, ask him/her what they consider to be the optimal angle of the implant they use and ask them how many implants they placed incorrectly, if they give you the deer in the headlight stare, run, don't walk out.

Chuck

While BHR and Smith & Nephew, Inc. are not implicated, The New York Times article gave me pause. Does anyone have more information about the devices mentioned in the article? Is there cause for concern?

Totally agree Chuck! Get THE BEST surgeon you can find! Its your health. You only get one shot.