Metal-on-Metal Hip Implants can Lead to Early Revision Surgery, Other Issues

Metal-on-metal hip implants have gained notoriety due to highly publicized recalls and thousands of lawsuits alleging that the devices caused early revision surgery and other injuries. Many studies have consistently shown that these devices are more prone to failure. Dr. Jeff Cartwright, an orthopedic surgeon, Chairman of the Department of Surgery at Skagit Valley Hospital and a faculty member of Pacific Northwest University of Health Sciences wrote a recent article in North County Outlook stating that the metal-on-metal design can lead to a number of issues when the surfaces of the implant rub together and release metal particles. Dr. Cartwright, who is also a veteran and a patient advocate, is one of many experts who have cautioned against these devices.

According to Dr. Cartwright, metal hip patients should also be aware of the following changes to their health:

• Heart: Chest pain, shortness of breath
• Nerves: Numbness in the hands or feet, difficulty walking, hearing and vision changes, headaches, ringing in the ears (tinnitus)
• Thyroid: unexplained fatigue, weight gain, feeling cold
• Kidney: change in urinating habits, swelling in ankles or feet
• Bone marrow: anemia, fatigue, weakness, potentially even blood cancers such as leukemia and lymphoma

According to the U.S. Food and Drug Administration (FDA), metal hip recipients can suffer from “adverse local tissue reaction” (ALTR), which is when the metal particles released from the implant cause damage to the bone and/or surrounding tissue. Signs of ALTR include pain, implant loosening, device failure and the need for revision surgery.

A number of manufacturers have recalled their metal-on-metal hip implants due to safety issues such as a high risk of failure and metal corrosion. One of the most publicized recalls was in 2010, when Johnson & Johnson’s DePuy unit globally recalled its ASR hip device. Smith & Nephew has also issued a metal hip recall.

Many lawsuits have been filed over metal-on-metal hip implants on behalf of plaintiffs who allege that their metal hip replacement caused early revision surgery, pseudotumors, pain, swelling and elevated metal ion levels. Recently, Biomet agreed to a $56 million settlement to end a multidistrict litigation over their Biomet M2a-Magnum implant.