"The decision to stop selling the hips isn’t related to safety or effectiveness, and it isn’t a recall." (Bloomberg News, 5/17, Cortez) This is the statement issued by an un-cited Johnson & Johnson spokesperson concerning its recent decision to stop production of all-metal replacement hips after August 31, 2013. (If you’re scheduled for a hip replacement this summer be sure your surgeon sees this article.) What was once a high-demand metal-on-metal hip implant, the Articular Surface Replacement (ASR), is now the contributing factor in over10,000 lawsuits being filed against J&J. Technically J&J is right, it’s not a recall as we think of it—but it’s most certainly a strong indictment by the patients with this particular implant and the surgeons who favored these models.
The New York Times reports a significant trend away from metal-on-metal replacement hips. "It is estimated that all-metal replacement hips — in which both the cup and ball of a device are made from metal — once accounted for about one in three hip implants used in the United States. However, the metal components rubbed against each other as a patient moved, creating tiny particles that could damage tissue, muscle and bone."
Typically a hip replacement is expected to last for 10 to 15 years, depending age, use, and other variables. The all-metal ASR is showing signs of deterioration after just a few years. In the face of this ‘trend’ surgeons have stopped using the J&J all-metal product in favor of replacement hips made from other materials. In 2007 the metal-on-metal hip held roughly 20% of the market both in the US and Europe—today those numbers are down to 2%. So, Johnson & Johnson is truthful in citing the falling demand as reason for discontinuing production of all-metal replacement hips. But, it’s a veiled excuse. No corporation is going to admit they’re making faulty products, particularly when that product is being surgically inserted in bodies and then failing in a way that causes physical pain and damage to bodies.
Imagine the medical costs, the stress and trauma of a surgery, weeks of rehab as you learn to walk with your new hip only to discover several years later that your new hip is damaging your body, including poisoning you with excessive levels of cobalt and chromium (heavy metals). Of course there are lawsuits.
I did a little research about hip replacement options. Each of the 4 types of product listed (see below) presents a small risk of damage to surrounding tissue and bone. It’s inevitable when we have artificial pieces of equipment inserted in our bodies. We rely on technological advances to give us better, safer products over time and we expect that older products will naturally fall out of demand. This may be a small factor in the decision made by J&J’s orthopedic division, DePuy Orthopaedics, but the lawsuits and the surgeons’ reluctance to use the product points to a more serious cause.
If you have a metal-on-metal hip implant you should follow up with your surgeon. Ask the doctor what brand of hip he used for your surgery. And, ask him to check for possible damage from a faulty hip replacement product.
If you want to read more about the types of available hip replacement options, this offers a good basic description: BoneSmart.org http://bonesmart.org/hip/hip-replacement-implant-materials/