Metal on Metal Hip Replacement

Hip replacement surgeries have been performed for many years. A hip fracture, arthritis, or the wearing down of a hip joint over a period of time all cause pain and decrease mobility. The objective of hip replacement surgery is to relieve pain caused by those issues. There are three types of hip replacement surgery–replace the entire hip, replace part of a hip, or hip resurfacing.

The basic components of a hip replacement device consist of three parts as follows:

• The stem. This is inserted into the thighbone (femur).

• A ball. This is attached to the top of a thighbone (femur).

• A cup. This attaches to the pelvis.

Today, implants are made up of a variety of materials–metals, ceramics, and plastics.

Metal Ball & Plastic Cup. These have been available since the 1960’s. The smooth plastic finish creates less rubbing against each part as the ball rotates inside the socket. This device does produce a significant amount of debris and will eventually fail. It could also lead to osteolysis.

Ceramic Ball & Plastic Cup. Unlike the metal-on-plastic device described above, the plastic utilized in this artificial hip is especially dense. While the materials used in this device create a smooth surface and are very reliable, an issue of debris still exists along with the osteolysis risk.

Ceramic Ball & Ceramic Liner. Since the 1980’s, these reliable all ceramic hip replacement devices are recognized for being durable. They aren’t perfect, however. They have a reputation for shattering and, less harmfully, for creating a squeaking sound.

Ceramic Ball & Metal Socket. These are fairly new;  the first obtained approval from the FDA in 2011. Studies of their effectiveness are still underway.

Metal Ball & Metal Cup. These devices were meant to be durable so that they could be used by younger patients with active lifestyles. They have been shown to have numerous significant problems and have been linked to grave health issues, such as metallosis. Many of the problems are caused by flaws in the design and culminate in elevated failure rates with a few years of the initial surgery. A number of manufacturers have recalled their devices–DePuy and Stryker among them.

Complications

Many of the complications connected to hip replacement are associated with the materials used in the devices. Metallosis and osteolysis are two conditions related to these devices. Other complications include:

• Infection

• Bone death (avasular necrosis)

• Implant dislocation

• Implant loosening

• Fracture

• Calcification of soft tissue (heterotopic ossification)

Manufacturers & Models of Defective Hip Implants

There are dozens of manufacturers of hip replacement components which are failing early and are being found to be defective; most of us have seen the ads on television. The following are manufacturers and their various models of problematic and defective replacement hips:

• Biomet, Inc. – Their implant, the M2a, is a modular device that has many options.

• DePuy Orthopaedics – Developed three replacement hips: The ASR Xl Acetabular, the Pinnacle, and the ASR Hip Resurfacing Systems.

• Smith & Nephew – Recalled the liner of its R3 Acetabular System on June 1, 2012.

• Stryker Orthopaedics – Recalled two hip replacement systems in July, 2012. The ABG II and the Rejuvenate Systems.

• Wright Medical Technology, Inc. – Wright makes two products: their Conserve Plus Total Resurfacing Hip System, in addition to the Profemur Z Hip Stem.

• Zimmer Holdings – They are facing lawsuits over the Durom Acetabular Component.

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