Hip Implant Failure Can Cause Metal Poisoning & Dislocation

Reported Risks & Complications

Several international regulatory agencies have issued alerts about the safety of metal-on-metal hip implants, as well as the United States Food and Drug Administration (FDA). Hip manufacturers Zimmer, Wright, Stryker, Depuy, and Smith & Nephew have all recalled defective hips to protect the health of their patients.

There are certain risks inherent in all hip and knee replacement surgeries, just like there are risks involved with any type of surgery. The biggest issue, however, is that even if your hip or knee surgery is completed with little-to-no complications, patients are experiencing serious side effects from metal implant failure that causes injuries and may require revision surgeries to rectify. Some of the side effects and injuries reported to the FDA include:

• Dislocation
• Metal poisoning
• Bone fracture
• Joint infection
• Local nerve damage
• Implant loosening or breakage
• Bone loss known as osteolysis
• Swelling near the implant
• Popping, grinding, clicking and squeaking

Metallosis and Metal-on-Metal Hip Implant Failure

Metal-on-Metal hip implants were designed to last longer than other types of implants because there is less device wear when the metal components rub against each other. There is also less chance of dislocation and a decreased chance of device fracture with these implants.

Despite these apparent design features, metal-on-metal hip implants can sometimes cause significant complications. When the metal components rub against each other, they can cause small particles to settle in and around the joint. Some of these particles are also released into the bloodstream and can cause serious reactions in some patients.

Metal particles that settle around the joint can damage the surrounding bone and tissues, called adverse reaction to metal debris.

The metal particles that are released into the bloodstream can cause symptoms and illnesses elsewhere in the body. This is sometimes referred to as metallosis. The FDA warns patients with the following symptoms to tell their doctor they have a metal-on-metal hip implant:

• Skin rash
• Cardiomyopathy, a chronic disease of the heart muscle
• Neurological changes, including changes in hearing or vision
• Psychological status change, including depression or cognitive impairment
• Kidney failure
• Thyroid dysfunction, including neck discomfort, fatigue, weight gain, or feeling cold

The FDA encourages patients with metal-on-metal hip implants, but who do not show signs of metal toxicity or device failure, to still check in with their doctors every one to two years.

Problem Brands of Hip and Knee Implants

There are dozens of brands of hip and knee implants on the market today and many that have been recalled or withdrawn from the market by their manufacturers. These manufacturers are large medical device companies that often place profit over people.

Problem Hip Implants

DePuy Synthes

DePuy Synthes’ motto is “people inspired,” yet this large medical device company has come under fire for a number of problematic devices, including its hip implants. A subsidiary of Johnson & Johnson, DePuy Synthes has recalled some of its most popular hip implant brands for various reasons over the past several years. Some of these problematic brands include:

• Pinnacle
• ASR Acetabular and Resurfacing System

Smith & Nephew

This global medical device company’s values include performance, innovation, and “earning trust.” However, some of its most popular brands have been recalled in the past several years and the company has come under fire for major device failures. One of the problem brands includes:

• Birmingham Hip Resurfacing (BHR) System

Stryker

Stryker’s mission is to make healthcare better “together with its customers.” This mission is lost when you look at the number of problems associated with some of its most popular implant brands. The company has been scrutinized over a number of its hip implants, including:

• LFIT V40 Femoral Head
• Rejuvenate
• ABG II

Wright Medical

Despite Wright Medical’s motto of “focused excellence,” the company is facing a number of lawsuits over some of its most popular hip implant brands. These problematic brands include:

• Conserve
• Profemur

Zimmer Biomet

Zimmer Biomet is a medical device company headquartered in Warsaw, Indiana. The company’s promise is “your progress,” yet this medical device giant is facing hundreds of lawsuits over some of its most popular hip implant brands. These problematic brands include:

• Durom Cup
• M²a-Magnum

Problem Knee Implants

Like hip implants today, many of the major knee implant brands have come under scrutiny for device problems, including increased rates of implant failure and the need for revision surgery. Many of these implants are metal-on-metal devices that cause complications when metal ions are released due to the parts rubbing against each other. In other cases, the implants fail sooner than expected to do other reasons.

Many of the knee implants are designed by the same companies who manufacture problematic hip implants.

DePuy Synthes

DePuy faces a number of lawsuits regarding some of its most popular knee implant brands, including its newest line of knee implants. Lawsuits regarding DePuy claim the glue that usually holds the implants in place does not stick properly to the patient’s tibia and can cause early device failure.

Zimmer Biomet

Zimmer Biomet is facing lawsuits against a number of its knee implants, including its NexGen and Persona brands.

Lawsuits: Hip & Knee Replacements

There are thousands of lawsuits filed against the various manufacturers of certain hip and knee replacement implants. These lawsuits are filed in state and federal courts across the country, and some have been consolidated to streamline the litigation process for lawyers and attorneys on both sides.

When a large number of similar lawsuits are filed in different courts, one or more parties may call on the Judicial Panel on Multidistrict Litigation (JPML) to consolidate their cases into a  multidistrict litigation, or MDL. Coordinating similar cases into an MDL helps streamline the discovery process, especially in complex medical device injury lawsuits.

A handful of cases are usually chosen from the MDL’s pool of cases to be tried first. These are called bellwether trials and they help lawyers and attorneys on both sides test legal theories in front of a jury. The outcome of these trials can help move both parties in the direction of a global settlement. MDLs are different from class action lawsuits in that the cases are tried individually and any verdicts or settlements that are reached are specific to the case and not distributed evenly among all plaintiffs in the litigation.

Hip Implant Lawsuits

The following manufacturers are facing dozens, if not hundreds or thousands of lawsuits against their most popular hip implant brands, which were consolidated into MDLs by the JPML.

• Smith & Nephew BHR Hip Implant lawsuits were consolidated into an MDL in 2017 in the U.S. District Court for the District of Maryland. There were more than 120 lawsuits filed as part of the suit in November 2017 and more are expected to be filed.
• Stryker LFIT V40 Femoral Head component lawsuits were consolidated into an MDL in 2017 in the U.S. District Court for the District of Massachusetts and involved more than 130 lawsuits as of November 2017.
• Stryker Rejuvenate and ABG II Hip Implant lawsuits were consolidated into an MDL in 2013 in the U.S. District Court for the District of Minnesota and involved more than 1,860 lawsuits in November 2017. Over the lifespan of the litigation, more than 3,400 lawsuits were filed against Stryker.
• DePuy ASR Hip Implant lawsuits were consolidated into an MDL in 2010 in the U.S. District Court for the Northern District of Ohio and involved more than 1,640 lawsuits in November 2017. More than 10,000 lawsuits have been filed against DePuy regarding the hip implants over the course of the litigation.
• DePuy Pinnacle Hip Implant lawsuits were consolidated into an MDL in 2011 in the U.S. District Court for the Northern District of Texas. In November 2017, more than 9,200 lawsuits were filed as part of the litigation.
• Zimmer Biomet M²A Magnum lawsuits were consolidated into an MDL in 2012 in the U.S. District Court for the Northern District of Indiana, where more than 470 lawsuits were pending in November 2017. Over the course of the litigation, more than 2,700 lawsuits had been filed against the company.
• Zimmer Biomet Durom Cup lawsuits were consolidated into an MDL in U.S. District Court for the District of New Jersey in 2010. There were more than 250 lawsuits pending in the district court in November 2017, and over the course of the litigation, more than 700 lawsuits had been filed.
• Wright Medical Conserve Hip Implant lawsuits were consolidated into an MDL in the U.S. District Court for the Northern District of Georgia in 2012. In November 2017, about 510 lawsuits were pending in the federal court, and more than 630 lawsuits had been filed over the course of the litigation.

Hip and knee replacements are some of the most common surgeries performed in the United States, and can help people regain mobility and reduce pain in their joints. These surgeries have become more and more popular in the past couple decades. Between 2000 and 2010, the number of hip replacements performed in the United States more than doubled, and knee replacements were among the top 5 most common inpatient procedures among adults. These numbers are only expected to rise as medical device companies continue to introduce new implants to the market.

Like all surgeries, hip and knee replacements carry certain risks, and people undergoing these types of procedures should be aware of the potential complications that could occur. Some of these risks are inherent in all surgeries, while other risks may be due to the type of implant the surgeon uses to replace the joint. Hip and knee implants can be made from a number of different materials, and some implants can increase a person’s risk for complications more than others, especially if the patient experiences implant failure.

Who Needs a Hip or Knee Replacement?

Hip and knee replacements are most common in adults aged 45 and older, and doctors take into account a person’s overall health when determining whether or not surgery is the best option. Implants typically last about 15 to 20 years, and surgeries to replace worn implants are riskier and usually have worse outcomes than the first surgery.

Hip Replacement

Doctors may recommend surgery to people whose joint pain interferes with their daily activities and when other treatment options failed. Arthritis damage is the most common reason why people undergo hip replacement surgery.

Knee Replacement

Before deciding if knee replacement surgery is right for a patient, doctors will typically check the range of motion in the knee, its stability and strength. Doctors may also use a patient’s age, weight, activity level, knee size and shape when determining knee replacement surgery.

Types of Procedures

There are different types of procedures when it comes to hip and knee replacements. Some patients retain some mobility in parts of their hips or knees and may be candidates for partial replacement surgery. Other patients with extensive damage or severe pain may need a total hip or total knee replacement. A doctor will help patients determine whether or not surgery is the right option for them.

Total Hip Replacement

In a total hip replacement, also called total hip arthroplasty, surgeons remove damaged bone and cartilage from the entire hip, including the ball and socket.

The femoral head — the ball-like portion of the hip — is replaced with a metal or ceramic ball, and the damaged cartilage in the socket is replaced with a prosthetic cup. In some implants, this cup is made of metal which can lead to complications.

Metal on Metal Hip Resurfacing

This procedure is used as an alternative to total hip replacement for young patients with significant joint damage and who are expected to outlive the lifespan of their implant. During the procedure, surgeons replace the socket with a metal cup and reshape the femoral head, leaving most of the bone intact before placing a metal cap on top.

This procedure has fallen out of use among surgeons, however, because the metal cup and cap can rub against each other, releasing metal ions into the bloodstream and causing severe complications.

Total Knee Replacement

During a total knee replacement, or total knee arthroplasty, surgeons remove damaged portions of the joint and reshape the bone to accommodate the implant. Surgeons remove damage from the ends of the femur (thighbone) and tibia (shinbone), and may also remove damage from underneath the kneecap (patella). Metal implants are used to cover the ends of the femur and tibia and a plastic spacer is inserted between the metal pieces to create a smooth surface.

Types of Implants

Hip and knee replacements are designed to mimic the natural hip and knee joints. Hip implants use similar designs but are made from varying materials, while knee implants can differ in both design and materials used. Some of the materials used in both hip and knee implants have come under scrutiny for their potential to cause increased complications.

Types of Hip Implants

In the U.S., there are five basic types of hip implants which use different bearing surfaces. Surgeons will determine which implant is best for their patients, keeping in mind a patient’s age, weight, height, activity level, and cause of hip pain.

Metal-on-Polyethylene

These types of hip implants use a metal ball component that fits into a plastic, or polyethylene, socket component. Sometimes, only the lining of the socket component is made from plastic.

Ceramic-on-Polyethylene

These types of implants use a ceramic ball component and a plastic (polyethylene) socket component, or plastic socket lining.

Metal on Metal

In these implants, both the ball component and the socket component are made from metal. These implants have come under fire in the last several years because of their potential to cause serious complications. When the metal ball and socket components rub against each other during natural hip movement, metal ions can be released into the bloodstream. This can lead to a condition known as metallosis, which can be fatal if left untreated.

Ceramic on Ceramic

This type of implant uses a ceramic ball component and socket component with a ceramic lining.

Ceramic on Metal

The ball is made from ceramic and the socket has a metal lining in these types of implants.

Types of Knee Implants

The knee is a complex “hinge” joint and there are several different kinds of knee implants on the market today that mimic the motion of a normal knee. Some implants use the body’s own ligaments to stabilize the knee, while others replace them. There are also gender specific implants and implants that use different materials.

Posterior-Stabilized Designs

This is one of the most common types of knee implants. This design uses parts of the implant to replace the ligament that prevents the thigh bone from sliding forward too far onto the shinbone when the knee bends. It does this using the tibial and femoral components; the tibial component fits into the femoral component using a special bar, and together they do what the ligament does.

Cruciate-Retaining Designs

In these types of knee implants, the natural ligament that helps stabilize the knee is preserved. These types of implants may be suitable in patients whose ligament is healthy enough to stabilize the knee joint.

Bicruciate-Retaining Design

This type of knee implant is relatively new to the market and preserves all of the natural ligaments within the knee joint. This implant is meant to feel most like a natural knee joint because all of the ligaments are retained, however, not many studies have been conducted to show the pros and cons of this design.

Unicompartmental Implants

This type of knee implant is used in partial knee replacement surgeries — where instead of removing the entire knee joint, only a portion of the joint is replaced by an implant. These implants are smaller and are used to resurface just one side of the knee joint.

Tibial Component Designs

Fixed-bearing implants – This is the most common type of tibial component used. In this design, the plastic portion of the tibial component is attached to the metal implant beneath it, allowing the femoral component to roll on the cushioned surface. High-intensity activity can cause these types of implants to wear down more quickly than other types of implants and cause loosening. Loosening is one of the major reasons why joints fail and patients need revision surgery.

Mobile-bearing implants – This type of tibial component allows the plastic insert to rotate slightly inside the metal tibial component. This is meant to give patients a little more range of motion in the sides of their knees. This design is meant to last longer than fixed-bearing designs, however, little research has established the durability of these implants. These types of implants can also be more expensive than fixed-bearing.

Implant Materials

There are over 150 types of knee implants on the market today and they may use different materials for each component. Some implants are made from metal (titanium or cobalt-chromium based alloys) and use plastic spacers made from polyethylene. Other implants may use ceramic or a ceramic and metal mixture. Implants that are made from all-metal materials have been associated with increased complications because of the potential for the metal parts to rub against each other and release particles into the bloodstream.

Knee Implant Lawsuits

Several knee implant manufacturers are facing lawsuits over their problem implants. These manufacturers may also be facing lawsuits regarding their hip implants as well. Many of these problem brands experience higher rates of implant failure than others. Some of these lawsuits have been consolidated into MDLs, including lawsuits over the NexGen system.

Zimmer Biomet has faced over a thousand lawsuits regarding its NexGen Knee Implants. The JPML consolidated federal cases into an MDL in 2011 in the Northern District of Illinois where 290 lawsuits are currently pending. Over the course of the litigation, more than 1,700 lawsuits were filed against the company.

DePuy faces lawsuits over new knee system

DePuy Synthes is facing scrutiny over its newest generation of knee implants. The first lawsuit over this new-generation implant was filed on Sept. 13, 2017 in Tuscaloosa County, Alabama. The lawsuit comes on the heels of dozens of adverse event reports filed by DePuy with the FDA. These adverse events document premature failures of the knee, which results in loosening and premature failure.

In an article published in the Journal of Knee Surgery, several prominent orthopedic surgeons reported an unusually high premature failure rate related to the knee system. They said the failures may be due to the cement that is used to hold the implant in place. Apparently, the cement does not adequately stick to the tibial component of the implant, which results in loosening and destabilization.

Hip and Knee Implant Lawsuit Claims

Lawsuits against hip and knee implant manufacturers allege similar claims against the manufacturers of these devices. While the details of the cases may vary, the lawsuits allege similar claims, including:

• Designing and manufacturing a defective product
• Failing to adequately warn patients about the product’s risks
• Negligently designing, manufacturing, and selling a faulty implant
• Strict liability for manufacturing a defective product
• Breach of express and implied warranties

Who Might Qualify for a Hip or Knee Implant Lawsuit?

If you were injured by a defective hip or knee implant, including implant failure, you may be entitled to financial compensation. People who have experienced the following adverse effects may qualify for a potential lawsuit:

• Dislocation
• Loosening
• Revision surgery
• The serious complication metallosis

Filing a lawsuit against the manufacturer of a defective product can help patients win back time and money lost due to lost wages, medical expenses, and other problems experienced as a result of the failed device. If you were injured as a result of a defective hip or knee implant, call our offices today to see if you qualify for a lawsuit against the device manufacturer.

Knee Implants

Having served in the army and losing a limb or blowing out knee is never easy. However, due to advanced medical advancements, people are now able to get prosthetic that will be able to help them lead semi-normal life as they act to replace that part of the limb that was missing or not work well.

However, some patients of the DePuy knee have been of late experiencing a few complications due to the unusually high rate of tibial baseplate loosening. According to research that had been conducted by The Journal of Knee Surgery vol 30, it was found out that patients who had their knees replaced from three separate hospitals had been having issues with their prosthetic knees as this was an unusually high rate of early aseptic failures due to the failure of implant cement interface. When the prosthetic becomes loose in any way, one is then able to experience pain, muscle damage may end up happening, nerve damage and an infection may end up coming up and one may end up needing revision surgeries in order to completely cure the knee. One needs to understand that revision surgery in most of the cases, is normally more extensive as compared to the initial operation due to the fact that there is an increase in difficulty since it’s another procedure being done to help fix damage that was already done. This may prove to be very difficult.

DePuy knee replacement

A subsidiary of Johnson & Johnson, the DePuy Synthes is the owner of the knee which is a prosthetic leg device system. The knee system is able to feature an innovative newer design that previously had been supported to produce stability, durability and flexibility.

Knee replacement claims

One needs to understand that they are entitled to being compensated or settling in the event that they find that their knee is a bother. Given the fact that various complaints have been raised against this specific issue, it goes without say that one will end up suffering from the pain of having to go through the experience of the knee being re-implanted which is painful and the healing process is also a tedious process as well.

Hip implant lawsuit alleges Stryker negligence

On September 9, 2017, the very renowned and popular company known as Stryker, which is a hip implant manufacturing company, was facing a potentially big product liability legal issue which is surrounding one of their metal-on-metal hip replacement system. However, this is not the very first time in which their metal hip implant system has been pulled off the market for having put their patients at risk. Back in the year 2012, the company had to recall the Stryker ABG hip and Stryker Rejuvenate Hip due to them being faulty.

Former patients then were able to file lawsuits against them given that they claimed that the Stryker hip that had been implanted in them had brought about very serious complications such as metal poisoning, catastrophic failure and dislocation etc. which lead to the occurrence of injuries and the typical revision surgery.

On august 29, 2016, the hip implant manufacturing company was issued with an urgent warning since one of their hip implants had completely failed. The failure was so high that the number of lawsuits that followed them were really many due to the failure of the prosthetic that contained their LFIT (Low Friction Ion Treatment) V40 femoral head. The company was able to explain that the unexpected complaints that had been brought to them due to taper lock failure has been able to bring about the complete dissociation of the femoral head form the hip stem, dangerous metal poison in the hip replacement patients and excessive metal debris in the hip joint.

The hip manufacturing company is now facing claims of having failed to warn the patients and the physicians many years earlier when they recalled their ABG hip and Rejuvenate implants, which also included the LFIT V40 after the damage had already been done as some were experiencing major hip implant failure.

A background on the LFIT V40 femoral head.

An artificial hip implant normally is a combination of various parts that are able to work together to help in creating the hip system. The parts include:

• Femoral head
• Femoral stem
• Femoral neck
• Acetabular socket
• Liner

The LFIT V40 is basically the femoral head component that is used by most of the Stryker hip implant is the part that is able to replace the “ball” at the topmost part of the femur or upper thigh bone. The ball is then able to easily fit into the socket of the pelvis bone making the hip joint rotation possible.The LFIT V40 is the femoral head component used in many of the Stryker hip implants and can be better understood as the part that replaces the “ball” at topmost part of the femur or upper thigh bone. The ball then fits inside the socket of the pelvis bone which makes hip joint rotation possible.

The Stryker LFIT V40 Femoral Heads are used with the following replacement hip implant systems used over the past 17 years:

1. Stryker Citation Hip System (January 2000 and later)
2. Stryker Meridian Hip System (January 2000 and later)
3. Stryker Accolade 1 or Accolade TMZF Hip System (March 2000 and later )
4. Stryker Rejuvenate Hip System (December 2008 and later)
5. Stryker ABG 2 Hip System (November 2009 and later)
6. Stryker Accolade 2 Hip System (March 2012 and later)
   Of course, the LFIT V40 Femoral Head was designed to make the replacement hip implant more advanced than their previous models and competitors’ hips. Stryker claimed, in fact, that this design would minimize the risk of dislocation and maximize hip range of motion and stability. They also explained that the “Low Friction Ion Treatment” technology would significantly reduced friction in the hip joint which would provide a longer lifespan for the prosthetic hip. Unfortunately, actual real life case studies proved the opposite: the LFIT technology was actually becoming part of the problem by increasing the metal on metal wear and tear leading to metallosis, tissue damage, pain, swelling, immobility, and catastrophic hip implant failure.

Stryker hip replacement injuries

Studies Reveal Injury Risks Associated with Stryker LFIT V40 Hips

• 2014 Patient Study: Researchers discovered that metal corrosion in the hip joint could account for patients experiencing hip joint pain, tissue damage, pseudotumors, and bone damage. The metal corrosion may also be a major factor in patients who experience a “spontaneous dissociation” of the V40 femoral head from the stem.
• 2015 Patient Study: A separate study a year later similarly stated that corrosion developing between the metal surfaces in the hip joint appeared to be the most likely cause of pseudotumors and hip implant failures. This study seem to show that the corrosion forming on the LFIT V40 increased the likelihood of excessive friction in the hip joint.

• 2016 Patient Study: Nine cases of patients experiencing catastrophic hip implant failure were studied as they related to this corrosion and metal on metal friction condition forming in the hip joints. Doctors reported that patients tested abnormally high for cobalt and chromium in their tissue and blood stream. All nine patients were required to undergo revision surgeries to alleviate the injuries caused by the failed hip implant.

Symptoms & Injuries Linked to Stryker LFIT V40 Femoral Head

For those who have had a Stryker hip replacement procedure and are concerned about the LFIT V40 head causing implant failure, you should report any of the following symptoms to your physician immediately. If you find yourself experiencing these symptoms it may indicate the V40 femoral head is corroding, creating increased joint friction and may lead to serious injury.

Symptoms of hip implant failure may include:

• Swelling or inflammation
• Instability or reduced mobility
• Difficulty walking, standing or sitting
• Loosening or mild dislocations
• Intense or consistent pain

These symptoms may indicate that the Stryker LFIT V40 Femoral Head is failing and you may be at risk of the following severe injuries, which could require invasive revision surgery to correct:

• Catastrophic hip implant failure
• Spontaneous dissociation of the femoral head from the stem
• Elevated cobalt and chromium levels
• Metallosis (metal poisoning)
  Pseudotumors
  Tissue damage
  Osteolysis (bone damage)

The high incidence of patient complaints of symptoms and/or injuries related to the Stryker hip implants spurred recalls of the LFIT V40 worldwide:

• August 24, 2016: Health Canada recalls the Stryker LFIT CoCr V40 Femoral Head
• August 29, 2016: Stryker publishes their “urgent medical device product field action notification” to orthopedic surgeons and issues a voluntary recall of the LFIT V40
• September 27, 2016: Australian health officials receive an urgent warning regarding the potential health hazard associated with certain Stryker hip implants.