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Routine hip surgeries that can lead to lawsuits
Written by: Enjuris Editors
A hip replacement is a routine procedure that can still take a wrong turn. Your doctor, despite his best intentions, might not be able to stop your crippling pain – and he might even add to it. Then you’re left with corrective surgeries and lawsuits against manufacturers – or even the doctor who implanted the device. Meanwhile, how does the state of Tennessee approach these surgeries? Learn more about types of hip replacements, risks, lawsuits, how medical malpractice or products liability law might come into play – and reach out to a Tennessee attorney right here.
You’ve tried the yoga routines, the aquatic therapy, gentle exercise regimens, walking with a cane and massage therapy. You’ve taken NSAIDs and opioids; you’ve received steroid injections and even tried hypnosis. Everything has failed, and you still have crippling pain in your hip.
The last option, says your doctor, is a hip replacement. You never thought that you’d reach this point, but here you are.
You are doing your best to be informed before making a decision – or perhaps you’ve gone through with the surgery and looking at your options for a lawsuit. If you live in Tennessee, here are some basics about hip surgery replacement you’ll want to know.
Artificial hip implants in Tennessee
Many hospitals and medical facilities perform this procedure, with varying degrees of success. When it comes to lawsuits over hip surgery replacements gone wrong, Tennessee lawyers have focused on a number of artificial hip implant manufacturers, most of which have locations within the state and operate on a national level.
DePuy Orthopaedics, Inc., a subsidiary of Johnson and Johnson, recalled its ASR XL Acetabular metal-on-metal implant in August 2010 after the company was informed of a higher-than-average failure rate following surgeries. Tens of thousands of patients received the implant before the recall, which led to the first lawsuit being filed in June 2010. This means countless potential cases that could be consolidated in an MDL.
Smith & Nephew hasn’t had much more luck with their artificial hip surgery implants. A number of their products were recalled, including the R3 Acetabular System in June 2012 and its Birmingham Hip Resurfacing Femoral System in June 2015. Their issues included high failure rates, metallosis, implant disintegration and more. There are currently several dozen lawsuits against the company.
Stryker Trident PSL & Hemispherical Acetabular ceramic implants also faced a high failure rate. Patients noticed squeaking sounds when they walked, and – horrifically – shattering or fracturing of the implant. Stryker made a voluntary recall in January 2008, though not before receiving FDA warnings and numerous complaints.
Wright Medical Technology, Inc. has a lovely hip surgery replacement implant that causes pain along with crunching sounds. Their Conserve hip implant led to a November 2016 case in which they settled more than 1,300 revision claims for $240 million. That wasn’t even the first financial blow, and more cases await the company.
Zimmer’s Biomet Durom Cup implants resulted in many complaints of implant loosening and device failure. The company briefly recalled them in 2008 and removed them from Australia, but only because of the inadequate surgical instructions. It was estimated that up to 30% of patients would experience issues and 5.7% of the implants failed entirely. An MDL was consolidated in 2010, and many claims are going forward.
Who really needs hip surgery for a replacement?
A hip replacement removes damaged or worn-out bone from your body and replaces it with an artificial ball-in-socket joint. Parts that have been damaged by arthritis, fractures, the aging process and more can make normal activities difficult. Even sleeping can feel impossible.
Enjuris Tip: Anyone can need a hip replacement – even a kid.
Hip surgery (replacements) are recommended when lifestyle changes and other intermediaries fail. The following individuals are normally candidates for this type of procedure:
Post-traumatic arthritis: This type of arthritis tends to follow serious injuries. If the cartilage is damaged, it can lead to stiffness and pain.
Osteoarthritis: Age-related arthritis usually occurs in people aged 50 or older, though it can run in a family that suffers from the condition. The cartilage surrounding the hip bones wears away and the bones to rub against each other. This lack of a buffer results in hip pain or stiffness.
Rheumatoid arthritis: This autoimmune disease inflames the synovial membrane, which damages the cartilage between the bones.
Bone tumors: If these grow on the hip joint, they will affect how you move, which will most likely lead to surface tension.
Avascular necrosis: When blood supply is limited to the femoral head (such as after a dislocation or fracture), this can result in the bone’s surface collapsing and arthritis forming.
Childhood hip disease: Just because someone is young doesn’t mean they cannot be affected by hip issues. If a child suffers from structural abnormalities, it will affect them later in life.
What are the main types of hip replacement surgeries and implants?
Hip replacements are made of three pieces: the ball, the stem and the cup.
The ball, or the “femoral head component,” replaces the head of the femur. The cup – AKA the “acetabular component” – is implanted into the pelvis, and the stem is inserted into the femur.
Enjuris tip: Hip replacements usually last 15-20 years, though they can last longer.
Hip surgeries (replacements), in Tennessee and elsewhere, are either performed from an anterior view, which is from the front and considered more invasive, or posterior, which is from the back. Most doctors choose the posterior approach, as it is less invasive and allows the surgeon better visibility, though it does come with a longer period of recovery.
There are three types of procedures:
Partial hip replacement: Professionally called a hemiarthroplasty, this is when only one part (usually the head of the femur) needs fixing.
Total hip surgery replacement (THR): This is when an artificial joint replaces the entire hip structure. A surgeon will insert the hip stem into the patient’s femur, and then replace the head of the femur with a ball and the socket with a cup.
Hip resurfacing: This delays a total hip replacement, as implants don’t last forever (on average, it’s about 15-20 years). This can also be used to improve arthritis symptoms. Surgeons will replace the socket with a cup and then resurface the head of the femur instead of replacing it with a ball. A metal cover is placed atop the femur, which has a short stem inserted into the neck of the femur and provides stability.
As for the new hardware in your hip, there are many types. They are made from metal, ceramic, plastic or some combination. Metal-on-metal devices are no longer recommended, as they can lead to metallosis (or a shedding of metal particles within the body).
Metal-on-metal hip replacements are no longer in use – they can cause metallosis, or a shedding of metal particles within the body.
Types of implants used in Tennessee include the aforementioned metal-on-metal, as well as others:
Ceramic-on-ceramic: These are durable and reliable, though the FDA only recently approved their use in the United States despite being available since the 1980s. Downsides include a squeaking noise, along with the potential of fracturing or shattering.
Metal-on-polyethylene (plastic): This is the most common. Plastic is smooth and causes little friction within the socket. However, plastic debris can float within the body, which will cause the implant to fail or even result in osteolysis, or a loosening of the implant from the bone.
Ceramic-on-polyethylene: This plastic is far denser than those used in metal-on-polyethylene devices, though there are still risks of osteolysis. Its smooth surface is great for feeling less friction and its density makes it more reliable.
Ceramic-on-metal: This was approved by the FDA in 2011 and is still in postmarket analysis.
What are the risks of hip replacement surgery?
There are risks involved, just like with other surgeries. As mentioned above, osteolysis is a big fear among patients and occurs more often in revisional surgeries rather than primary procedures. More common risks, however, include:
Dislocation (occurs in 1%-5% of cases, more frequently upon revision)
Inflammation (1% of cases)
Different leg length
Femur fracture (when surgeon forces bone back into socket)
Migration of implant
Debris from implant causing complications
Heterotopic ossification (bone forming outside the skeleton where trauma occurred, also known as “calcification” of soft tissue, happens in up to 50% of cases, complications in 10%)
Early failure of implant
Periprosthetic fractures (tiny fractures around the implant)
Death during surgery
Enjuris tip: Calcification (bone growth outside the skeleton) occurs in up to 50% of hip replacement cases – though only 10% present with complications.
There are indeed faulty hip surgery replacement models that should be avoided. Models that have been the subject of lawsuits or device failures include:
Wright Medical Technology
Trident Hemispherical SH
Smith & Nephew
Metal liner of R3
Modular Redapt Femoral System
TriGen Hip Nail
Metal-on-metal implants have the biggest failure rate, and those have been the subject of many lawsuits against manufacturers. As of late 2017, more than 13,000 cases involving various hip implants are pending across the country.
Multidistrict litigations are pending, which means that a federal legal procedure allows for hundreds or even thousands of similar plaintiffs to consolidate cases and move through the system at a faster pace.