The hip replacement that could be poisoning you!

  • I am writing this post as an introduction to a VERY important matter a hip prosthesis the could be poisoning you, I know it’s a bit long, but bear with me for a little while
    What is a Hip  replacement?: this is a procedure that has as its objective the  replacement of  a malfunctioning joint, usually due to wear and tear on the joint.
    How is it done: The hip joint is located where the upper end of the femur, or thigh bone, meets the pelvis, or hip bone. A ball at the end of the femur, called the femoral head, fits into a socket (the acetabulum) in the pelvis to allow a wide range of motion.
    During a traditional hip replacement, which lasts from 1 to 2 hours, the surgeon makes a 6 to 8-inch incision over the side of the hip through the muscles and removes the diseased bone tissue and cartilage from the hip joint, while leaving the healthy parts of the joint intact. Then the surgeon replaces the head of the femur and acetabulum with artificial parts. The new hip is made of materials that allow a natural gliding motion of the joint (source)

    There are as you see above in the diagram two parts, one that looks like a ball, which is fitted into the femur, and the other in the acetabulum, creating an artificial articulation.
    The materials with which the prosthesis are made are many (ceramic and metal to name just two), but we are going to talk about metal on metal prosthesis.  In 2010 some models were recalled (DEPUY ASR™ ARTICULAR SURFACE REPLACEMENT and DEPUY ASR™ XL ACETABULAR).
    Why were they recalled? 
    - There was a higher than expected rate of prosthesis malfunction (Expressed by pain while walking or moving, limping, difficulty walking, and/or swelling around the hip area)
    - The friction between the metals led to tiny particles of metals (cobalt and chromium) to be:
                   - released into the blood system thereby causing a  danger of many side  effects, which included :Gastrointestinal Problems, Neuropathy (nerve damage), Thyroid Problems, Kidney Failure, Skin Disorders, Hemorrhage, Pulmonary Syndrome, Elevated Cancer Risks, Reproductive System Problems, Impaired Liver Function and depression.
    - Accumulation of neighborhood areas: Over time, the metal particles around some implants can cause damage to bone and/or tissue surrounding the implant and joint. Soft tissue damage may lead to pain, the implant loosening, device failure, and the need for revised surgery (the old device is removed and replaced with another one). (Source)
    There are many practical consequences for the patient:
    - If you have a prosthesis which is metal on metal as named above, you are recommended to have it checked and a consultation with your surgeon is the best course of action for you.
    - If you have a different brand of metal-on-metal prosthesis, there is a guide by the Spanish Association of hip surgery (SECCA).
    This guide indicates that:
    If you have ANY symptom of prosthesis malfunctioning, this could include:
    -      Limping
    -      Difficulty walking
    -      A popping, squeaking, or grinding noise coming from your hip
    -      Pain felt in the hip, leg, or groin
    -     Swelling around the hip joint
    You Should visit your GP immediately to ask for a  test for malfunctioning a (loosening ) of the prosthesis, and also to check you levels of chromium and cobalt.
    Also, if you are a woman it is considered by some that you have an annual or bi-annual chromium and cobalt blood levels check.  Anybody who has a larger than normal prosthesis (usually young people, more than 36 mm in diameter of the head), should also be checked for levels of chromium and cobalt.
    There is an ongoing lawsuit in Malaga against the manufactures of the prosthesis recalled. The last vista for the trial here was the 22nd November, and they are expecting the verdict of the first case.
    I will write another post with that story, so people can comprehend the importance of checking if you have a metal on metal prosthesis.
    If you know somebody with one of the recalled prosthesis, contact me to get in touch with the group that are supporting the people that had those prosthesis
    Also, if you know anybody with a prosthesis, tell them to check what type of material the implant was. It is on the Medical notes (discharge report) from the hospital where they had the procedure.
    Do you think the manufacturers of this prosthesis are responsible for the damages caused by it?
    I would love to hear your comments