Hip replacement surgery is major surgery, but for many patients it restores mobility and a life free from chronic pain. A number of medical device companies make artificial hip systems. There is a lot of variety in these hips. They can be made of various materials. Some are complete hips. Others are components that can be used interchangeably.
While for many people a hip replacement ends up being successful, for others it can quickly turn into a nightmare. There are always risks with surgery, but when a joint is being replaced the possible number of complications grows. This is especially true with artificial hips that have proven to have higher than normal failure rates. If you have suffered because of a bad artificial hip, you can join the thousands of similar patients who have sued the companies making these faulty products.
Reasons for Hip Replacements
People who have damage to the hip joint that causes significant pain and loss of mobility are candidates for hip replacements. The damage may occur from an accident, but more often it is from a chronic condition that causes damage over time. These conditions include osteoarthritis, rheumatoid arthritis, and osteonecrosis. In the past, hip replacement was reserved for patients over the age of 60, but with newer hips that last longer and can sustain more physical activity, young people who need new joints may receive an artificial hip.
The hip joint is a large ball-and-socket joint, which gives it a wide range of motion. The socket, or cup, is called the acetabulum, and is part of the pelvis bone. The ball is on the top of the femur, or thigh bone, and is known as the femoral head. Cartilage covers the inside of the cup and the surface of the ball to cushion the joint. Ligaments surround the joint to keep it in place.
Types of Hip Replacement Surgeries
Artificial hips and components may be used in a total hip replacement, a partial replacement, or a resurfacing surgery, depending on the needs of the patient. In a total hip replacement, also known as a hip arthroplasty, a surgeon removes the cup and the ball and replaces them with artificial parts. A typical total artificial hip joint includes a stem that is inserted into the top of the femur, ball on top of the stem, a cup or liner to replace the socket, and a liner that goes between the new ball and cup.
If damage to a hip joint has not affected all parts of the joint, a surgeon may do a partial hip replacement. Just one half, either the cup or the ball, is replaced with an artificial part. Another possibility when the joint is not totally damaged is to do a resurfacing. The surgeon removes damaged material from the femoral head, or the cup, or both, and then inserts a liner into the cup or a cap on the head to replace the damaged material.
Most people receiving a hip replacement spend three to five days in the hospital after the procedure, but then may spend between three and six months fully recovering mobility. Most people participate in physical therapy during those months, which helps speed the recovery. During the recovery period, patients are not supposed to bend over too far or be too active.
As with any type of major surgery, there are risks that a patient will experience complications, either during or after the hip replacement. General types of complications possible include infections, blood clots, and bad reactions to anesthesia. During hip surgery, it is possible that a bone will become fractured or that a deep-joint infection will take hold.
After a hip surgery, the most common complication is a dislocation of the joint, which can be very painful. This is why patients are supposed to limit mobility and bending throughout the recovery period. Other complications that may arise include inflammation at the site of the hip, a loosening of the new joint, legs that are different lengths, and wear or even breakage of components in the joint.
Artificial Hips – Types and Materials
Types of hip joints are largely defined by material. All artificial joints include the same basic parts: the stem, ball, and cup. Some hip systems include all the pieces, while others are available with mix-and-match components, so that surgeons can make the best fit for each individual patient. The three materials from which hip components are made include plastic, ceramic, and metal.
The oldest style of hip is metal-on-plastic. A downside to this type is that movement in the joint can cause pieces of plastic to wear off. The same is true of ceramic-on-plastic hips. The pieces of plastic can implant in tissues and cause damage. Ceramic hips are durable, but also brittle. They are prone to shattering, and in some people may make a squeaking sound.
Metal-on-metal hips are newer than the other types and are designed to be more durable and longer-lasting, but they come with some serious risks, like metal poisoning. Another new design is the ceramic-on-metal hip. The first one was approved by the U.S. Food and Drug Administration (FDA) in 2011. It is hoped that they will be durable, but have fewer problems that the metal-on-metal hips.
Hip Failures and Revisions
When artificial hips fail, patients may have to have revision surgeries. These are surgeries designed to fix or completely replace a damaged artificial hip. Having a revision is not ideal, but even with sturdy, durable hips, the joint does not last forever and a replacement may become necessary.
Some patients have unfortunately had revision surgeries long before they should have due to hips that failed early. A revision may be necessary if a hip becomes loose, if there is a deep infection, if the joint has caused bone death or tissue damage in the surrounding area, or if the joint or bone nearby has fractured.
Certain artificial hips have proven to fail early, requiring revisions at higher than average rates. DePuy, a division of Johnson & Johnson, Smith & Nephew, Biomet, Zimmer, and Stryker Orthopedics have all produced hips or hip components that later proved to be faulty and to have high failure and revision rates. Some have been recalled, while for others an FDA warning and further studies were warranted.
One of the most problematic types of artificial hips on the market today is the metal-on-metal hip. Several manufacturers have designed and made these hips to provide a more durable joint that could stand up to greater physical activity and last longer before needing to be replaced. These hips have higher failure rates than other types.
One major problem with the metal-on-metal joint is that when the metal components rub together, small fragments wear off and enter the surrounding tissue and blood. This can cause a localized reaction or even metal poisoning. Another problem is that these hips are not always durable as they are supposed to be. Some have been found to fret, corrode, and even break. The FDA has required several manufacturers of metal-on-metal hips to conduct more tests on the implants and has also issued warnings and statements about the risks of using them in patients.
Many people who received hips that failed early have sued the companies that made them, and many have been successful in getting settlement money. Biomet has paid over $50 million to people harmed by their hips. Johnson & Johnson has settled for $2.5 billion over its DePuy hips and Zimmer has paid as much as $9 million in individual cases. If you have faced hip revisions due to a faulty artificial hip, you too could seek compensation.