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Joseph H. Saunders
Joseph H. Saunders
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Metal on Metal Hip Implants-New is not Always Improved

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Today’s New York Times discusses the American impuse to assume that the newest innovation is probably the best solution in hip implant and hip replacement surgery. The writer points out what many implant physicians and medical device lawyers have known for some time. That is that failure rates for all metal on metal hip implants are significantly higher than failure rates for the traditional metal ball implant with a plastic or polyethylene cup liner.

My professional legal experience litigating these cases for hip implant patients and consumer confirms the conclusions reached by the New York Times writer Barry Meier. I have seen how the pressure within the medical device industry among the different manufacturers to gain market share has resulted in promotion of the various brands of metal on metal hip implants eventhough there has been serious concern in the medical community about the dangers of metallic debris released into the patient’s body from the implants.

The brands of metal on metal hip implants in the market place in the U.S. over the last five years are the DePuy ASR, the DePuy Pinnacle Ultimet, the Zimmer Durom Cup, the Biomet, and the Birmingham or BHR which is manufacured by Smith & Nephew.

Surprisingly, DePuy initially recommended that failed DePuy ASR implants be replaced with the metal on metal DePuy Pinnacle. The DePuy Pinnacle also is sold with polyethylene liners that could have been recommended instead of the metal on metal implant.

Currently, there are three coordinated forums for metal on metal hip implant lawsuits in the U.S. federal district courts. The DePuy ASR cases are in the U.S. District Court in Toledo, Ohio, the DePuy Pinnacle cases are in the U.S. District Court in Dallas, Texas, and the Zimmer Durom Cup cases are in the U.S. District Court in Newark, New Jersey. These cases are not class action lawsuits. They are individual cases that will be sent back to the state of the residence of the individual plaintiffs if they are not settled. The attorneys for the hip implant patients are investigating the role that over promotion and misleading advertising by the implant manufacturers contributed to the belief among physicians that these new metal on metal implants were better than the traditional polyethylene lined cup implants.

The New York Times article reports an estimate that about 500,000 patients in the U.S have received all-metal hip implants in the U.S. over the last decade. About one third of hip implant patients in the U.S. in 2008 were receiving metal on metal implants. That percentage of metal on metal implants is now steadily declining and many physicians are returning to the use of the traditional implants as a result of the high failure rate of the all-metal implants.

The U.S. Food and Drug Administration, the FDA, allowed the DePuy, the Zimmer, The Biomet, and the Smith & Nephew metal on metal hip implants to be marketed to the public without any clinical trials. Perhaps the FDA and the medical community will be more skeptical in the future of claims by the device manufacturers that a new improved but untested device is better than devices that have been proven over time to be effective and reliable.

Hip implant surgery using the traditional implant prosthesis has had a very reliable and successful track record.