Generally, a hip replacement is expected to last for 15-20 years.  It will eventually start to wear off and patient may need a revision surgery. But recent reports indicate that metal hip devices are failing earlier than expected.  There is an estimation made by the National Joint Registry for England and Wales (NJR) that nearly 1/3 of ASR hip replacements fail in six years. DePuy Orthopedics, a subsidiary company of Johnson & Johnsons Inc., marketed the ASR hip.

The British Hip Society held its annual meeting last March 2011.  Several doctors and patients discussed about MoM hip implants’ failure rates, particularly the DePuy ASR.  The results of the failure rate were 21% at 4 years and 49% at 6 years, higher than what was expected. From the gathered data, doctors are cautioned that “Pain in this group of patients should be taken seriously and investigated appropriately.”  When a hip implant starts to fail, pain can be one of the earliest complaints.

In the United States, all-metal hip is becoming a big concern. The New York Times made a review on the federal data of the Food and Drug Administration that the agency received numerous complaints about the all-metal hip this year, larger than the number of complaints of the past 4 years combined. The manufacturers were ordered by the FDA to examine the health of their patients and to study the frequency of hip failure.

The British Joint Registry follows around 2, 100 patients who have received the DePuy ASR.  Of those patients in the registry who have received the metal implant 6 years ago, roughly 29% have had it replaced. For patients who received the device 5 years ago, the failure rate is lower at 17% but this may increase over the following years.  Even if the patients being followed by the registry are not from the US, doctors and patients still pay close attention to the agency because there is no such registry that exists in the country.

According to the spokesperson of DePuy, the 6-year replacement rate presented by NJR “should be interpreted with caution because it is based on a small number of cases.”  These figures are a great warning sign and increase health concern of patients who are recipients of the device. Doctors and patients should carefully consider whether or not to use metal-on-metal hip implants. The DePuy Orthopedics, with the various failure rate reported about their product, has ordered a worldwide DePuy hip recall.
 


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