"Boomeritis" Buying into Hip and Knee Implants—but at What Cost?


. By Jane Mundy

Hip and knee replacements are one of the biggest moneymakers for medical device manufacturers, but at what price to hip and knee implant recipients? Judging from the recent metal-on-metal knee and hip recalls and mass tort litigation against device manufacturers including Stryker, Smith & Nephew, Howmedica and more, countless patients are suffering and facing revision surgery.

Carol says her hip replacement has been "a total disaster." She has been in constant pain since surgery, which can't be controlled with the strongest of pain meds. Dave (not his real name) had two Stryker knee replacements on each leg when he turned 50. Five years later, he is "suffering severe pain, swelling and stiffness in both knees to the point of almost not being able to stand for any long period of time." He also says the nerves seem to be affected since pain is shooting up from the knee into the hip area.

John had a metal-on-metal knee replacement in 2007 and says his knee is worse now than before surgery. "It constantly hurts, inflames and buckles without warning. I have to walk up or down stairs sideways because my knee can't take any pressure—it will collapse from my body weight and I'm not a big guy.

"I complained to my surgeon six months after the replacement and he told me the pain would go away, but I'm still waiting. After I had the replacement I spent 30 days in the rehab center and I'm not looking forward to going through that again."

Not only do Carol, Dave and John have metal-on-metal (MOM) implants in common. They are all relatively young to have undergone hip or knee replacement surgery, and are most likely looking at revision surgery.

The New York Times (March 2010) reported that "metal on metal" implants have been used in about one-third of the approximately 250,000 hip replacements performed annually in the US, mainly because it was thought that ball-and-socket joints made from metals like cobalt and chromium would be more durable and last longer.

Not so, according to medical device expert Lana Keeton. She says MOM implants were designed to last longer for younger and more active people, but instead, they have a shorter life span. And they are creating another, very serious problem: in some cases, high volumes of metallic debris from MOM knee and hip implants have been absorbed into a patient's body.

If you are under the age of, say, 55, and considering a knee or hip implant—especially the latter—just about any orthopedic surgeon will tell you to wait a few years. These devices at the best of times have a "shelf life" of about 10–15 years, so what's the sense of having to undergo two surgeries?

This begs the question: why were MOM implants designed for a younger patient in the first place? According to Dr. Nicholas DiNubile, a suburban Philadelphia surgeon, "Boomeritis" or "fix-me-itis" is on the upswing, and medical device companies are hedging their bets that younger and more active patients—the majority of baby boomers—won't want to wait. But the MOM implants are sometimes failing within two or three years of implantation, which spells revision surgery.

Medical device companies are making their shareholders happy by selling MOM implants. New research shows that knee replacement surgeries have doubled over the last decade and more than tripled in the 45-to-64 age group and hips are following suit. But these companies are also facing huge lawsuits.

"Johnson and Johnson recently announced that they put aside $1 billion for litigation and settlement costs," says attorney Kevin Hart. "This problem is like a tornado—the rumbling started last year with problems and failures, but it's getting much worse. Most people we have met have been to their doctor and need another knee or hip replacement surgery but the big question is when…"


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