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Metal hip replacement problems arise years later for many patients PDF Print E-mail

By Jan Rahn
Managing Editor
“A blessing in disguise” is how Lisa Engel describes the left hip pain she was having back in July. A doctor’s appointment led to the discovery of  something much worse—only it was in her right hip.
Engel has now received a second right hip replacement.
Following a bizarre twist of events, Engel is recovering and hopeful that she will soon be walking around as normal.
Walk, sit, stand—that’s what we humans do over and over—and it takes a good hip joint to do it.
Unbeknownst to Engel, the right hip that was replaced in 2007 was about to redirect her life.
In July of this year, when she saw a physician because her left hip was developing similar symptoms to those she had prior to initially having her right hip replaced, he immediately became concerned when looking at x-rays.
“He told [my husband] it was a mess,” said Engel. “He said metal was sloughing off and it had shaved the tissue and bone.”
Long story short—Engel was facing another surgery, but not on the hip that was giving her trouble. She did not have any discomfort at all in her right hip—she couldn’t believe what the doctor was saying about the need for a second replacement, and the sooner the better.
The doctor told her the ball joint was tilted and there was metal rubbing on metal in her right hip.
He did a blood test and found that the levels of chromium and cobalt, which are supposed to be under 10, were at levels of 25 and 53, respectively.     
Doctors wasted no time informing Engel her failed metal hip required replacement—what they didn’t anticipate was that there was not enough metal left to hook more hardware onto.
Engel had to have a donor bone put in place so that new hardware could be attached. Time passed as she recovered from surgery in having a donor bone put in place while also being monitored for rejection. Then new hardware was finally put in—this time a ceramic ball was used, not a metal one.
Getting back to the left hip—nothing will be done for a few years, said Engel. The doctors gave her a cortisone shot 10 days before the right hip surgery and she was told she needs to be a little older before surgery will be performed on the left joint.
“After what I’ve been through, I’m not sure I’d do that surgery again,” she said. “I just hope it [cortisone shot] keeps working.
She recently had a checkup and things are progressing nicely from the surgery she so unexpectedly had on Aug. 30.
Engel said the donor bone has healed and she can start putting a little weight on her leg/hip joint. She continues to use a walker and crutch, but is hopeful that she’ll be able to become completely mobile before too long.
Engel is sharing her story in hopes it will alert others to the potential for problems if they have metal hip replacements.
“I just don’t want anyone else to have to go through what I did,” said Engel.
According to a September story in The New York Times, there is heightened concern in the U.S. about the all-metal hips such as the one Engel first received back in 2007.
An analysis by the Times said the Food and Drug Administration had received more reports about problems with the all-metal hips in the first six months of this year than it had in the previous four years combined.
The FDA has ordered producers of the devices to study their failure and to examine the health implications for patients.
A report in Britain indicated early failure rates for all-metal devices were far higher in women than in men.
Traditional artificial hips typically last 15 years or more before requiring replacement, however, the all-metal models are failing in large numbers of patients within a few years.
Back in 2007, Engel had no idea she would be amongst thousands of other patients whose all-metal artificial hips would be failing.
She watched a television news report this summer about a Denver woman in her 30s who faced the same dilemma. According to the newscast, lawyers and the medical field are looking into the widespread problem.
According to one estimate, nearly 500,000 patients in the U.S. have received an all-metal replacement hip.
Until a recent sharp decline in their use, all-metal hip implants accounted for nearly one-third of the estimated 250,000 replacements performed in the U.S. annually.