MRI May Predict Metal-on-Metal Hip Implant Failure

Metal-on-metal hip implant lawyers at Pintas & Mullins Law Firm highlight a recent study suggesting that MRIs may be useful for identifying patients with these implants who will require revision surgery before symptoms even begin to manifest. Metal-on-metal hip implants, such as those made by DePuy, Zimmer, and Stryker, have exceedingly high rates of failure.

Due to their defective design, metal-on-metal hip implants often cause inflammation of the joint lining, called synovitis, long before symptoms appear in the body. Magnetic resonance imaging (MRI) may be used by physicians to identify such inflammation and diagnose patients that have a high risk of implant failure. Such identification will allow patients to undergo revision surgeries before any painful symptoms become problematic.

The study was conducted by researchers at Hospital for Special Surgery and published in the Journal of Bone and Joint Surgery. The chief of the Division of Magnetic Resonance Imaging at the Hospital for Special Surgery stated that patients should not have to wait until they are in pain to determine the health of their hip implants. By the time pain and other symptoms start occurring, tissue around the joint have already been damaged, and possibly even deteriorated, making revision surgeries that much more difficult.

Making matters worse, those implanted with metal-on-metal hip implants are often elderly or stricken with other ailments that make major surgeries complicated and dangerous. Metal-on-metal procedures initially involve resurfacing the hip joint, placing metal caps over the head of the femur matched with a metal cup placed in the pelvic socket.

This metal-against-metal implant was once championed as the latest technology from medical device manufacturers, touted for being exceedingly long-lasting and effective. The reality, however, has been dismal, with extraordinarily high rates of failure in patients, as well as metal ion poisoning, which is known as metallosis. With time, the metal caps and cups wear against each other and produce metal debris in microscopic particles, which results in metal ion release. These metal ions impact local tissue and other bodily systems, resulting in tissue death and strain on internal organs, such as the kidneys.

Implant failures are often attributed to tissue death surrounding the implant site, which results in fluid collections that are typically undetectable on radiographs or computed tomography scans(CT). Patients with an abundance of tissue death also, unfortunately, have poor outcomes after revision surgery.

Study researchers divided nearly 70 patients with metal-on-metal hip replacements into three groups: those without symptoms (22 hips), those with symptoms with mechanical causes, such as dislocation or implant loosening (20 hips), and those with symptoms of no known cause (32 hips). All patients had similar ages and implant durations.

All patients underwent an MRI, and scans were subsequently evaluated by two musculoskeletal radiologists who were unaware to which group each patient belonged. Synovitis (inflammation of the joint lining) was detected by MRI in 68% of the asymptomatic hips, 75% of the mechanical symptomatic hips, and 78% of hips with unexplained pain. X-rays and serum ion levels were also tested, although neither of these methods predicted the actual amount of internal damage.

As a result of this high failure and metallosis rate in metal-on-metal implants, more than 11,000 patients recently called on the FDA to re-classify the devices as high-risk. About two months before this request, the FDA indeed proposed this very action, though a decision is not yet final.

This outcry is a response in no small part to recent litigation surrounding metal-on-metal hip implants. Hundreds of thousands of patients have been injured by these defective implants, and are now seeking compensation for their suffering. The most recent case, decided by a jury in March 2013, resulted in an $8.3 million payout by DePuy to a man implanted with its ASR XL implants.

The patient accused the manufacturer of knowingly marketing a defective device that was later recalled. Like thousands of others, he experienced premature implant failure and was forced to undergo painful revision surgeries. He testified saying that he was forced to live in constant pain, was unable to walk, and also suffered from metallosis.

Metal-on-metal hip implant attorneys at Pintas & Mullins Law Firm are currently investigating cases involving DePuy, Stryker, and Zimmer devices. If you were seriously injured by a metal-on-metal hip implant, you may be entitled to significant compensation for your medical bills, lost wages, and pain and suffering, and should contact a skilled attorney as soon as possible.


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