It used to be that hip replacement and resurfacing surgeries were reserved for patients over 60. Artificial hip systems were not sturdy enough to last as long or to withstand the activity that a younger patient would need. Newer devices have changed this, though, and DePuy Synthes, a division of Johnson & Johnson, is one company that contributed by designing sturdier artificial hips that could stand up to the needs and the timeframe of younger patients.
DePuy made the Pinnacle and ASR hip systems to be durable enough for young patients, but unfortunately they have caused a lot of problems and cost the company billions. These particular hip systems have been proven to have greater failure rates and to cause more cases of serious health complications, like metal poisoning. Many lawsuits have been filed against DePuy, and if you have one of these hips you too could sue for money damages.
The Need for a Hip Replacement
Hip replacement surgeries use synthetic devices to replace part of all of the hip joint. A doctor may recommend this surgery for a patient to help reduce pain and increase mobility. Damage from conditions like osteoarthritis, rheumatoid arthritis, bone cancer, or osteonecrosis, can cause enough pain and lack of mobility in the hip joint to interfere with daily life and regular activities. When this happens, hip surgery is an option to help a patient be more mobile and to be able to live with less pain.
Hip Replacement and Resurfacing
There are two main types of hip replacement surgery: a total replacement of the joint and resurfacing. The hip joint is a ball and socket. The top of the femur bone in the leg has a rounded shape that fits into a socket or cup to form the hip joint. When there is extensive damage to the joint a patient may get a total hip replacement, in which the socket and the ball are replaced with artificial components, including a stem to connect the ball to the leg bone.
If the damage is less extensive, a patient may only need resurfacing. This means that the surgeon can save parts of the natural joint by resurfacing the ball or the socket and removing the damaged portions. The ball can then be refitted with a cap and the socket with a cup or lining. Both surgeries are major procedures and require a long period of recovery.
Risks of Hip Surgery
As with any major surgery there are risks to be considered before making this decision. While undergoing anesthesia for such a major procedure, patients are at risk for having a heart attack, for the formation of blood clots, for excessive bleeding, for infections, which can become serious, and for a bad reaction to the anesthesia.
More specifically, hip surgery carries certain risks, including dislocating the new joint, nerve damage, bone fractures, and infections deep I the joint. The two legs may end up being different lengths after surgery, which can lead to pain. The artificial joint or components may also fail, which can cause serious pain, inflammation, and a need for further surgeries to correct it.
Metal-on-Metal Hip Implants
Artificial hips may be made of ceramic, plastic, or metal. Metal is the sturdiest material, and so metal-on-metal hips were designed to be longer lasting implants for younger patients. Unfortunately there have bene all kinds of problems with hips that have a metal socket rubbing against a metal ball in the joint. Over time, metal wears off and can cause metal poisoning and other problems.
Some of these have been seen in DePuy’s ARS and Pinnacle hip systems. Metal-on-metal hip joints have the potential to cause metal poisoning, but also bone fractures in the area of the hip, dislocation of the hip joint, and loosening of the implant in the body. Revision surgery is needed to correct many of these problems.
Two hip systems made by DePuy that caused problems in patients were the ASR XL Acetabular System, a total hip replacement implant, and the ASR Hip Resurfacing System, used for resurfacing surgeries. In 2010 DePuy announced it would be phasing these out of use, but then a few months later announced that they should not be used at all. The company stated that the systems were failing early in some patients.
These metal-on-metal hips were supposed to last longer than other hips, but many patients were experiencing the pain and discomfort of a failed hip, especially those who were shorter or had weaker bones. Most of these patients had to have more surgery to correct the problems or to have an entirely new hip implanted. The ASR systems have mostly been used in other parts of the world, but the ASR metal cup was approved for use in the U.S. by the Food and Drug Administration (FDA) in 2005.
Problems with the Pinnacle
As the ASR systems were recalled, the Pinnacle acted as the successor and many patients in the U.S. received this implant. Unfortunately the Pinnacle had nearly the same problems as the ASR. Doctors following the failures found that more than ten percent of implanted Pinnacle systems failed two to three years after surgery. Patients with Pinnacle hips have experienced product failure, but also dislocations, pain, swelling, and poor mobility.
One of the most troubling problems seen with the Pinnacle has been contamination of the blood by chromium and cobalt from the metal-on-metal hip. The high levels of these heavy metals in the blood can cause heart disease, brain disease, kidney damage, thyroid problems, and damage to soft tissues. DePuy has not admitted to any problems with the Pinnacle hips and has not recalled them, but the FDA is requiring all makers of metal-on-metal hips to conduct long-term safety studies.
Thousands of lawsuits have been filed against DePuy and Johnson & Johnson over the ASR and Pinnacle hip systems. Many of those for the ASR were grouped together in a multidistrict litigation. Johnson & Johnson eventually agreed to settle in those cases to an amount of $2.5 billion. Some Pinnacle cases are ongoing, but as of March 2016, the company settled some of these for upwards of $500 million. If you were affected by a Pinnacle or ASR hip system, you can file a suit. Talk to a lawyer about your options and get the money you deserve.