Hip implants causing concern

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Mon, 30 Jan 2012 6:08p.m.

The metal-on-metal implants were recalled in 2010

The metal-on-metal implants were recalled in 2010

By Alexandra O’Hara

Safety concerns about metal-on-metal hip replacements are rising in Britain, as one Auckland lawyer says New Zealand authorities need to launch their own investigation into the implants.

James Elliott, who had one of the implants at 43, says they're more harmful than many think, and if action is not taken there could be serious consequences.

He says there were “relatively two choices” when he had the operation in 2008 – a ceramic working surface, or metal-on-metal.

“I was advised at the time due to my relative youthfulness for this operation that metal on metal would give me the longest lasting result,” he says.

However, the implant was removed 18 months later, shortly before being recalled when medical regulators became worried about the number of people – like Mr Elliott – who were forced to have operations redone.

Now an investigation by a British newspaper claims the devices could be more dangerous than first thought, especially concerning the long-term effect of having metal in the body.

Over 500 New Zealanders have the replacements, and since the 2010 recall these have been monitored closely by the Orthopaedic Association.

Mr Elliott says this isn’t enough, and an investigation needs to be launched into how the implants made it into the country in the first place.

He says “an inquiry by Parliament, preferably the Health select committee” would be the most appropriate course of action.

The Ministry of Health says they are following the situation closely and anyone with concerns should contact their doctor.

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Comments

08 Feb 2012 09:15p.m.

Steve wrote:

One has to be careful to distinguish between the later generation metal on metal hip replacements (MonM) and the early generation designs that have been in service for almost three decades. These earlier types were pioneered by the Swiss, have a "small head" ball size of 28 or 32mm diameter and after over 250,000 implants, mainly in Europe, have not been subject to the issues that we are now seeing with the large ball diameter ( over 40mm and up to 56mm) designs that are the subject of the current failure issues. However unfortunately it seems that all MonM hips will be tarred with the same brush, which is unfortunate because in appropriate indications the small diameter designs have seen excellent service over many many years. There are 1000's of NZ patients with these early designs in situ and they should not be burdened with the worry of the current state of affairs with large diameter metal on metal designs.

04 Feb 2012 08:18p.m.

Kag. wrote:

to Mike for his comments 1 Feb 2012. Crap, you have not a clue what you are talking about. How would your wife like to call 111 3 times during late April and early may to take you to hospital because you are unconscious with on going pain. This is not only about Metal on Metal there are many other problems. Pain from the operation is is just another.

04 Feb 2012 03:24p.m.

James Elliott wrote:

I am the James Elliott featured in this story. Thanks to those who have commented. First I have to record that Mike's comments are hopelessly misinformed. This is a massive worldwide issue affecting 93,000 patients in respect of the De Puy recalled parts. It has been described by independent experts as the biggest disaster in orthopaedic history. It has been covered extensively in international media and a quick Google search will show you a myriad of independent articles (eg. several cover stories in the NY Times) showing how serious this is. The issue has or is also being investigated by authroties such as the FDA in America and the Australian Senate. Also, John Doe and Ron are right in that there are a huge number of issues thathave to be looked at but there's only so much you canget acros in a sound bite. That's why my central message is that there simply has to be an investigation by the Parliamentary Select Committee on Health to look ata range of issues including: 1. How did these parts come to be used in NZ? 2. What was the interaction between Johnson & Johnson and the specialists who recommended them? 3. What is being done to assist those of the 507 NZ patients whose lives have been sverely affected by this issue? 4. What is being done about the concerns of the long term affects of potential metal poisoning? 5. Why won't Johnson & Johnson engage on a comprehensive and transparent compensation programme for NZ patients? 6. How much of the financial burden of dealing with this diaster has been placed on the NZ taxpayer through ACC claims and shouldn't that burden be met by J&J which is one of the world's largest multi-national companies? 7. And by no means last but why is that somne patients were not advised of the product recall that took place in late 2010, only became aware due to the media coverage and then found that they were facing some potentially severe medical issues? There are more issues but limited space for a post. Thanks.

01 Feb 2012 08:39a.m.

Mike wrote:

Sounds like a 'What If' witch hunt - probably generated by joint replacement comapnies themselves in competition.

Joint replacement have run into the problem for years that they dont last like real bones. This is a 2-part problem as the body rejects foreign bodies - like implants and joint replacements, plus a joint tends to wear with 2 surfaces rubbing without lubrication (as the lubrications that would work well outside the body are toxic).

In the case of breast implants they had major recalls over cancer worries yet the studies showed lower cancer amoung those who had the implants than those without which was probably caused by the bodies immune system being boosted to attack the foreign body. People then looked at the implants removed in horror for not being pristine looking after being implanted. The Russians used that as a medical treatment, inserting a chip in patients shoulders which had the effect of boosting immune function very cheaply (about 10-15%) to keep much of the population healthier.

In a joint they want to have a product that is stable that isn't affected by the bodies attacks much. They also want something that wont create wear that leads to faster wear. They probably run into the the disimilar metals problem too if 2 different metals which is why they have used a metal ball joint into a non-metal cup previously.

In the end they will probably come up with 'Do you want mobility with the new joint' or 'do you want a few weeks longer to live' type trade off. Then again just having surgery probably shortens peoples lifespans a little ...

What has happened is someone, probably a competitor joint replacement company has come up with a theory that metal on metal may put metal ions in the body, so without evidence they have launched the unsafe campaign. They need to find out if the theory holds water, and that will take years the speed medical moves. I expect they will find an ion trail, but it to be insignificant to a patients health.

31 Jan 2012 06:15p.m.

key wrote:

Nothing a bit of lithium grease wouldn't fix.But seriously ,there is a bucket load of money being made by the guys that sell these hips to the surgeons , one place to start ?.

30 Jan 2012 10:59p.m.

Ron wrote:

This news story has not gone anywhere deep enough....this issue is a minefield - I note that the recalled joints are not named in this article....the public need to know that Depuy(Johnson & Johnson) are not the only metal on metal joints to be causing major problems,the other companies have not recalled even though their metal prothesis are causing health problem! Yet I understand that NO metal on metal hip prothesis are being used in the last two years! Patients do not make the choice of what type of prothesis will be fitted,their surgeons do! People have been fitted with metal on metal devices that within a very short space of time have failed and created huge health problems for the unfortunate recipitents! The powers that be are trying to play this down - as this comes under 'Treatment Injury' previously known as Medical misadventure! Referring to John Doe post: yes I can see that your summary is highly likely scenario too - Good on TV3 but this issue needs much deeper investigation and help for the people who are left to suffer while trying to fight the 'system' and bureaucacy to get these artifical joints which are painful and creating metalosis among other effects for innocent people, through no fault of their own!!! All patients with metal on metal hip prothesis should be immediately provided with the right to have them removed urgently by the patients chosen surgeon at no cost to the patient!!!!!

30 Jan 2012 07:55p.m.

John Doe wrote:

Perhaps James Elliott is barking up the wrong to tree? Maybe his question should be why the NZOA surgeon chose to implant the unproven implants into him in the first place. If the surgeon was called before Royal Commission or Court and asked if he had been influenced by the Depuy, a Johnson and Johnson company's spending. Namely monies given to him in the form of royalties, educational grants to his educational bank account ( which is conveniently not audited) or overseas trips to e.g. Skiing meetings in Vail Colorado USA, and of course the many dinners at restaurants like Antoines with visiting company DEPUY surgeons..... I guess if the public could more clearly see the money trail that influences the NZOA surgeons, they may understand why the unproven and now dangerous implants are being pumped into them....

30 Jan 2012 07:23p.m.

Catherine wrote:

Awesome - NOT! I just had a total hip replacement in November, I'm 35 and sure hope this particular hip implant is not the one thats in me! Now they tell me its much worse than they thought having metal in your body!I'm hardly healed and then this news comes out, real assuring... :(