Hip replacement surgery is a major procedure, but one that has helped many people get relief from pain and enjoy mobility again. This type of surgery is typically done when damage from arthritis, injury, or other conditions have resulted in enough pain and lack of mobility to make everyday life challenging. The entire hip joint may be replaced, or only components of the joint that are most damaged.
Several medical device manufacturers make artificial hip systems, and some of these have proven to cause serious complications. Hip replacement side effects may range from an artificial hip coming out of place to metal poisoning and infections. The hips most implicated in these complications, which have led to recalls and lawsuits, are metal-on-metal hips.
Hip Replacement and Artificial Hip Systems
It may be a major surgery, which comes with risks and potential complications, but hip replacement surgery is life-changing for many people. Arthritis, bone cancer, injuries, osteonecrosis, and other conditions can cause damage to the hip joint that makes life difficult. Accumulated or sudden damage can cause a serious amount of chronic pain and can significantly lower mobility. When these two symptoms become debilitating enough, hip replacement surgery is typically recommended.
To replace the hip joint, a surgeon must remove the damaged bone tissue and replace it with artificial parts. An artificial hip joint includes three parts: the cup or liner that sits in the acetabulum, which is the socket on the pelvic bone, the ball or head of the femur that fits into the acetabulum to give the joint movement, and a stem to connect the ball to the femur.
In the past, most hip replacements were reserved for older patients who would not be very active. This was because artificial hips were not durable enough to last for younger, more active patients. This changed when medical device manufacturers developed the metal-on-metal hip, designed to be stronger, more durable, and longer-lasting.
While metal-on-metal hips held great promise for young people and more active older adults, for too many patients they have proven to cause a number of terrible side effects. Some of these hips are failing at a much greater rate that is expected. Some corrode in the body, loosen or come out of place, and all of them rub metal against metal, releasing small fragments of metal.
There are several manufacturers that have made metal-on-metal hips that have proven to be problematic. Some of these companies have faced lawsuits and settlements, while others have had to recall parts that proved to be faulty:
- DePuy, which is part of Johnson & Johnson, saw high failure rates for the Pinnacle and ASR hip systems and had to issue some recalls.
- Biomet hips have proven to have high failure rates and to cause metallosis, or metal poisoning in some patients.
- Stryker recalled its Rejuvenate and ABG II systems over hip replacement side effects like metal poisoning and loosening of the joint.
- Zimmer has had to recall an acetabular cup which did not adhere to the bone well enough. It was called the Durom acetabular cup.
- Smith & Nephew also recalled a cup from its R3 Acetabular System because it led to a high number of revision surgeries.
Side Effects of Metal-on-Metal Hips
The most serious side effects of hip replacements seen in the last decade or two have been the result of metal-on-metal hips. These hips that were supposed to be better and more durable are proving to have higher failure rates and to cause serious complications in too many patients. The problem has been bad enough that the FDA has issued warnings about specific hip systems, but also about metal-on-metal hips in general.
Several of these hip replacement side effects are related to the metal material of the hip system. When the metal ball of the hip rubs against the cup or liner, which is also metal, small fragments get knocked off of the joint. For some people this doesn’t seem to matter, but for others it can cause an adverse local tissue reaction, or if it gets into the blood stream, metal poisoning. A local tissue reaction is irritation at the site of the joint, which includes inflammation, pain, swelling, and sometimes infections.
The adverse local tissue reaction can also lead to the joint coming loose because of damage to the joint or the surrounding tissue. Loosened hips can move out of place causing serious pain and lack of mobility. When this happens the hip is considered to have failed and the patient needs revision surgery. Some need multiple surgeries both to replace the hip and to fix damage that it caused to the local area.
If the fragments of metal from the hip get into the blood in significant quantities, a patient may also experience metallosis, or metal poisoning. Metal-on-metal joints are made from alloys that may include nickel, chromium, titanium, cobalt, and other types of metal. In the blood these metals can cause symptoms and damage to bones, tissue, and the nervous system. Metal poisoning can also cause heart problems, changes in mood, vision problems, skin rashes, hearing loss, thyroid problems, and even cognitive impairments.
Revision Surgery to Treat Hip Replacement Side Effects
The side effects of a metal-on-metal hip are often severe enough to require one or more revision, or corrective surgeries. The high rate of revision after implanting metal-on-metal hips is one way the FDA and others have measured the failure rate of these hips. The more revisions needed, the more the hip is considered to have failed. Revision rates are high for many of the mental-on-metal hips still on the market.
Many people who have had to have revision surgeries for their hips have sued the companies making the hips, including Biomet and Johnson & Johnson. The cost of revision surgeries is high, both in terms of medical bills and pain and suffering, not to mention the disruption of normal life and the ability to work. If you experienced some of these terrible side effects of a hip replacement, you too may want to sue the company that you feel failed you.