One of the complications that patients with a defective DePuy Orthopaedics hip implant may face is metallosis, a condition in which metal particles build up in the tissue around the implanted joint. Thousands of patients with these recalled implants will require revision surgery to replace the device.
Symptoms of metallosis include:
• Pain around the hip joint
• Difficulty walking
• Swelling around the implant area
• Rash that is a sign of dying tissue
Those symptoms may indicate these severe problems:
• Loosening, when the implant does not stay attached to the bone in the right position.
• Fracture, where the bone around the implant may have broken.
• Dislocation, where the two parts of the implant that move against each other are no longer aligned. This happens because tissue around the joint becomes inflamed and weakened, and can’t hold it in place.
• Damage to the nerves, tissues and muscles near the implant area
Background of the hip recall
The hip implants in question are as the ASR XL Acetabular System and DePuy ASR Hip Resurfacing System. In August 2010, the DePuy Orthopaedics company, a subsidiary of Johnson & Johnson, issued a voluntary recall of two hip replacement systems. DePuy stated that “13 percent of patients (1 in 8) who had received the ASR total hip replacement needed to have a revision surgery.”
How metallosis develops
As the ball and the socket of the implant rub against each other, friction scrapes off microscopic ions of cobalt and chromium, which enter the lubricating fluid that surrounds joints. These particles disperse and accumulate in nearby parts of the body, and also flow through the bloodstream.
The immune system reacts to the metal ions by automatically inflaming the area around the debris. The inflammation is the body’s attempt to contain the foreign particles in the inflamed area so the metal can't spread to the rest of the body.
How metallosis affects the body
Along with the symptoms listed above, there are other problems associated with metallosis.
During revision surgery, doctors often find dense black staining of the synovial membrane and surrounding muscles. The membrane is a sac filled with fluid that helps certain joints move freely. In the case of the DePuy hip implant, it appears that the immune system inflames cells in the synovial membrane, causing synovitis. Synovitis is painful, since the inflammation prevents the joint from rotating properly.
Surgeons also often find pseudotumors, masses of inflamed cells that look like tumors. They can be either solid or fluid-filled and have been found more commonly in women and persons of small stature. Patients who had pseudotumors usually had gradually increasing pain.
Doctors have also found greatly elevated levels of cobalt and chromium in hip revision patients. Both metals have been linked to cancer, and cobalt poisoning (cobaltism) has serious side effects including neurological (brain) damage, heart irregularities, and seizures.
The dangers posed by the DePuy hip implant failure become ever more disturbing as time goes by. DePuy has offered to cover “reasonable and customary costs of testing and treatment, including revision surgery,” and to reimburse patients for “reasonable out-of-pocket expenses.”
Obviously the damage that can potentially be caused by one of these defective devices is far greater than that. The severity of the health issues involved and DePuy’s limited offer of compensation mean you need the counsel of an expert hip-replacement attorney. The attorneys at Egerton Law can help.
New York Times:
More information from Egerton Law:
Documents requesting access to your medical records (Which you should not sign.)
Why you must retain possession of your hip joint (explant) after surgery.
The story of a lost explant.