The Unacceptable Revision Surgery: DePuy Hip Implants

Hip replacement surgery is an invasive procedure with a lengthy recovery period. It’s not something anyone hopes to go through at all and certainly not more than once. Unfortunately, that has been the case for a large number of patients who received DePuy metal-on-metal hip implants. After going through one hip-replacement surgery, an unacceptably high rate of patients with a DePuy implant had to do it all over again—in what is known as a revision surgery—because of a problem with their implant.

While most hip implant recipients hope that one implant will last the rest of their lives, 1 in 8 recipients of the DePuy products needed a second, corrective surgery within 5 years. According to an article on Arthritis Today, that rate is nearly double the industry average. In other words: unacceptable.

As a result of this high failure rate, on August 24, 2010, DePuy Orthopaedics, which is part of Johnson & Johnson issued a voluntary recall of two hip implant devices: the ASR XL Acetabular System and the ASR Hip Resurfacing System. The first product is used in a traditional hip replacement, while the second is a partial hip replacement. Globally, over 93,000 of these medical devices have been used to treat patients needing full or partial hip replacement.

Of course, not every patient who received a DePuy implant has needed a revision surgery; or at least not yet. But, the recall is reason enough to put patients on the alert. So what is the concern with these hip implants? And what should patients be watching for?

The concerns are various, but a primary one is that the implant devices fail to stay properly attached to the bone, which causes the implant to loosen. This in turn, leads to infection and dislocation.

Another concern is not necessarily unique to the DePuy implants, but to metal-on-metal hip implants in general. When both the “ball” and the “cup” components of a hip implant system are metal, the friction created when they rub against each other—i.e., when the recipient walks or runs—means that tiny metal particles are released into the bloodstream. This can lead to serious complications for the patient, including damage to the surrounding bone and tissue, or even the development of a condition known as cobaltism or cobalt poisoning.

Careful medical monitoring of the DePuy implants is a must for anyone who has received one of these devices. Being particularly alert to groin, hip or leg pain; swelling around the hip joint; or a limp or change in walking ability are indications that something is off and a revision surgery might be necessary. It’s also necessary to pay close attention to changes in health overall—such as chest pain or shortness of breath; numbness, weakness, changes in vision or hearing; fatigue, feeling cold and weigh gain; change in urination habit. Any of these symptoms could indicate that there is too much metal in the blood stream.