Latest updates on hip replacement surgery

Friday, August 30, 2013

For years, it has been a widely held notion that individuals who engage in excessive, strenuous physical activities, such as running, are likely to develop osteoarthritis affecting the knees or the hip, medical experts say. This has been attributed to increased stress and impact that weight-bearing joints in the body may sustain from the high-impact exercise. A recent study, however, offers a different vantage point to this long-standing view, claiming that runners stand at a lower risk of developing osteoarthritis and eventually requiring hip replacement surgery for the joint disease than people who choose walking as their primary exercise.

Paul Williams, an exercise epidemiologist at Berkeley Lab’s Life Sciences Division, reportedly set out on a study that zeroed in on how running and walking may affect a person’s risk of osteoarthritis and hip replacement. The recent study involved nearly 90,000 participants, 74,752 of whom were runners, while 14,625 were walkers. After following both groups for an average of seven years, more than 2000 runners reportedly received diagnosis of osteoarthritis, while over 250 of them went through hip replacement surgery. On the other hand, nearly 700 walkers were diagnosed with the arthritic condition and more than 100 have also gone through hip replacement.

Study results reportedly suggest that volunteers who ran more than one mile each day showed a 15 percent decreased risk of osteoarthritis and 35 percent lower hip replacement risk, compared to individuals who lead a sedentary lifestyle. No significant changes have been observed even in runners who ran at higher mileages or participated in multiple marathons in a single year. While other factors may have also played a role, findings also reportedly revealed that running may have significantly contributed to low osteoarthritis and hip replacement risk due, in part, to the physical activity’s connection to lower body mass index.

Osteoarthritis is a joint disorder which usually results from the progressive breakdown of the protective cartilage in joints, as was described by medical journals. Also known as “wear and tear” arthritis, osteoarthritis has reportedly taken an increasing role in prevalence, affecting 20 million people from the American population alone, according to government statistics reports. Individuals who may have developed the arthritic condition particularly in the hip may experience pain, stiffness, and limited mobility, making regular, day-to-day activities difficult to perform and causing a major impact to their quality of life.

Hip replacement surgery, also referred to as total hip replacement, has been the medical recourse of most patients whose osteoarthritis in the hip has progressed, according to health experts. It is a surgical procedure that involves the removal and replacement of a severely damaged hip joint with an artificial component known as prosthesis or hip replacement implants. Medical experts point out, however, that hip replacement surgery is only recommended to patients whose symptoms of osteoarthritis have become severe that non-invasive treatments no longer suffice to provide relief.
In August 2010, Johnson & Johnson (J&J), the world’s leading provider of diverse healthcare products, altogether with its orthopedic division DePuy Orthopaedics, conducted a global product recall of two of its most lucrative and popular hip replacement systems, the ASR XL Acetabular System and the ASR Hip Resurfacing System, online sources say. This action by the health care giant was reportedly initiated after it had been determined that more than 12 percent of these chromium-cobalt hip devices failed in less than five years. They have also been reportedly identified as a potential source of health risks, including complications from premature implant failure. In possibly preventing further damage from this adverse event, medical experts, consumer safety groups, and the United States Food and Drug Administration encourage those who have received ASR hip implants to undergo a blood test that could detect a possible DePuy hip replacement failure.

Similar to other metal-on-metal hip products on the market, the ASR hip replacement systems have been surrounded with controversies that describe their safety on a less favorable light. They have been the subject of numerous studies and thousands of adverse event reports, most of which link the ASR hips to early implant failure and complications related to metal toxicity. Health problems allegedly stemming from the ASR hip replacement systems have also drawn a series of lawsuits against DePuy and its parent company J&J.

Considered as one of the country’s most prominent product recalls, the so-called DePuy ASR hip replacement recall reportedly affects more than 93,000 implants distributed internationally, including about 37,000 units sold in the US alone, according to online media reports. Studies have also shown that these devices have been associated with failure rates greater than those of other similar hip implants on the market. Patients who may have received these implants are recommended to remain on the lookout for the following symptoms of a potentially failing implant: hip pain,swelling, joint dislocation, hip discomfort, limited mobility, or bone loss due to inflammation in the affected area.

With or without these symptoms, however, DePuy ASR hip recipients are still encouraged to submit themselves to a blood test which could analyze the levels of metallic debris that may have accumulated in the area surrounding the hip. Medical experts point out that increased levels of these particles could be an indication of a possible hip implant failure. As these minute metal particles build up, they may also be distributed through the blood, leaving hip implant recipients highly susceptible to health risks associated with metal poisoning, including persistent pain, pseudotumors, tissue death, or recurring infections. In most cases, recipients who have experienced hip implant failure have been subjected to early revision surgery to remove and replace their implants.

Osteoarthritis, being the most prevalent form of arthritis, has been reportedly recognized as a leading cause of disability among adults, health experts say. In fact, government statistics shows that approximately 40 million people in the United States are enduring the symptoms associated with the debilitating joint condition. Medical journals further describe osteoarthritis as a progressive joint disease related to aging and the breakdown of cartilage at the ends of the bones and joints. Although it has been commonly reported to affect the knees, osteoarthritis may also affect the hip and other areas such as the hands or lower back.


Symptoms associated with hip osteoarthritis have been associated with limited range of motion, decreased flexibility, and poor quality of life among those afflicted by the joint disease, health experts say. Patients with hip osteoarthritis commonly experience persistent pain in the groin, thigh, hip, or buttocks region. As the condition progresses, the pain may also become severe, causing patients to experience more discomfort and lesser flexibility. Other symptoms of hip osteoarthritis may also include swelling or tenderness in the hip joint, a grating or grinding sensation in certain movements, and stiffness at the affected joint, especially after a long period of inactivity.

Risk Factors

As an age-related condition, osteoarthritis has been commonly reported to develop in middle-aged and elderly adults. On the other hand, younger people are not an exception to the joint disorder. People who may have sustained severe injuries from an accident or high-impact physical activities or those who may have been born with bone deformities or defective cartilage also stand at an increased risk of developing osteoarthritis.

Although there are no clear scientific indications, osteoarthritis has been found to develop more likely in women than in men, according to medical experts. Obesity or added body weight as well as occupational repetitive stress have also been recognized as risk factors of osteoarthritis.


While there is no known cure for osteoarthritis, medical experts cite that there are various treatments designed to alleviate pain and improve joint function in patients. Alongside lifestyle changes, doctors often recommend non-surgical treatment options, including anti-inflammatory medications or pain relievers, and low-impact physical activities that promote strength, maintain mobility, and improve balance and flexibility.

Patients may also be advised to seek the assistance of a chiropractor for joint mobilization treatments and various types of therapies, including ice and heat therapy or electrotherapies. Some individuals, who wish to further delay the possibility of surgery, also often take advantage of complementary and alternative therapies, such as acupuncture or yoga.

On the other hand, patients whose symptoms of hip osteoarthritis may have failed to improve despite conventional or non-invasive treatments may be advised by their doctors to consider joint or hip replacement surgery, health experts say. It is a surgical procedure in which a surgeon removes and replaces the damaged joint with a prosthesis. While hip replacement surgery has been reportedly considered as the safest and most reliable procedure in all of medicine, some devices used in the procedure, particularly metal-on-metal implants, have been reported to fail earlier than expected, leaving patients vulnerable to serious health risks.

Wednesday, August 28, 2013

Initially carried out in the 1960s, knee replacement surgery has significantly advanced its effectiveness as improved surgical instruments have been designed, newer techniques have been developed, and better understanding of the knee joint's function has been recognized, medical experts say. Also referred to as total knee replacement, knee replacement surgery has been reportedly considered in recent years as one of the most successful surgical procedures in all of medicine. It also accounts for more than 600,000 procedures carried out in the United States every year, according to government statistics reports.

Knee replacement surgery entails the removal of the shinbone, femur, and knee cap in a damaged knee joint, as was described by medical journals. The damaged joint is then replaced with artificial components commonly referred to as prosthesis or knee replacement implants. Most patients who are asked to undergo this procedure have sustained severe knee joint damage from injury or trauma, osteoarthritis, or other related bone or joint conditions.

Severe osteoarthritis of the knees has been reportedly recognized as the most common reason for which patients in the US undergo knee replacement, medical experts say. Also known as  degenerative arthritis, it is a progressive joint disease which typically occurs as a result of the gradual breakdown of the cartilage that protects the ends of the bones. It is characterized by pain and stiffness in the affected joints, limiting an individual, mostly older adults, from performing normal daily tasks.  While the age-related joint disorder frequently affects the knees, osteoarthritis may also develop in the hips, neck, hands, or lower back. Other types of arthritis that have been found as common causes of knee pain include rheumatoid arthritis and post-traumatic arthritis, while sources of joint pain in younger patients include ankylosing spondylitis and other similar musculoskeletal conditions.

There are patients who may wish to delay the possibility of a knee replacement surgery, according to health experts. Depending on the severity of their condition, doctors initially recommend non-surgical treatment methods that may include lifestyle changes, physical therapy, or pain medications. On the other hand,  patients whose symptoms may have failed to respond to non-invasive techniques are ultimately then recommended to undergo knee replacement surgery for pain relief, better joint function, and improved quality of life.

Much like other surgical procedures or treatments, knee replacement surgery may also be accompanied by certain risks. These may include complications such as infections, blood clots, or fracture in the bone around the artificial joint. Despite this, orthopedic experts highlight that the risks are minimal and that complications only occur in about two percent of total knee replacement cases.

Tuesday, August 13, 2013

Patients undergoing a major orthopedic surgery, such as hip replacement, stand at an increased risk of developing blood clots at some point following the procedure, medical experts say. As means of preventing blood clot formation, surgeons or doctors usually prescribe anticoagulants or blood-thinning medications, which primarily function by reducing the blood’s ability to clot. In comparing certain anti-clotting drugs, a group of researchers reportedly found that extended use of aspirin may be a safe, effective, convenient, and even inexpensive alternative to dalteparin in preventing venous thromboembolism (VTE) after total hip replacement.

Medical experts highlight that VTE is one of the most commonly occurring complications following joint replacement surgery.  It is a condition characterized by the formation of blood clots within a vein, manifesting through deep vein thrombosis (DVT) -- a blood clot which predominantly forms in deep, large veins, usually of the legs or pelvis.  In some cases, DVT may lead to pulmonary embolism, which occurs when a segment of a blood clot within a deep vein breaks off from a vessel and spreads to the lungs.

Canada-based researchers, spearheaded by Dr. David R. Anderson from Dalhousie University, set out on a study to find out if aspirin would be an effective alternative to extended use of low-molecular-weight heparin. In a multicenter randomized, controlled trial involving more than 770 hip replacement patients, study participants were initially administered a low-molecular-weight heparin called dalteparin via subcutaneous injection for 10 days. Patients were then randomly divided into two groups and were assigned to daily use of dalteparin injections and aspirin placebo tablets, or placebo injections and oral for 28 days.

During the 90-day follow-up period after randomization, 0.38 percent or one out of 386 participants from the aspirin group had a VTE event, according to the study featured at On the other hand, a VTE event was reported to occur in 1.3 percent or five out of 400 patients from the dalteparin group. Study findings, which were published online in the June edition of Annals of Internal Medicine, reportedly suggest that aspirin is neither inferior nor superior to dalteparin in VTE prevention.  Additionally, results showed that aspirin poses lesser risk of bleeding events than dalteparin, and is also effective from a cost perspective.

Thursday, August 8, 2013

Metal-on-metal (MoM) hip replacement implants have been considered as one of the major advancements in orthopedic medicine, permitting hip replacement surgery to be conducted not only in older adults but also in younger, more active individuals, medical experts say. Despite the benefits these innovative medical devices have to offer, all-metal hip devices have also been surrounded with controversies that describe their safety on a different light. They have been the center of a growing number of hip replacement lawsuits currently being faced by leading orthopedic device manufacturers in the United States and the subject of numerous research studies year after year.

One of these studies involved a retrospective review of about 400,000 hip replacement procedures performed between 2003 and 2011. Findings by a group of British researchers reportedly revealed that patients with MoM hip implants may be more likely to require additional surgery to repair or replace their device.  After gathering and analyzing data from the National Joint Registry of England and Wales, the research team found that nearly six percent of patients who received MoM implants had to undergo another surgical procedure to replace them. Researchers indicated that only 1.7 to 2.3 percent of patients who received ceramic or plastic joints required revision surgery.

In view of these findings, study authors reportedly called on doctors to cease the use of MoM hip implants. Study author Ashley Blom from the University of Bristol also added that patients who do not require total hip replacement have no reason to take the risk of undergoing the procedure, especially with various alternative treatment options in place. The government-funded study was published online in The Lancet in March 2012.

Additionally, MoM hip devices have been associated with elevated levels of potentially toxic metals in a patient’s blood, according to online media reports. In a safety communication released by the US Food and Drug Administration in January 2013, the federal agency raised the alarm over the propensity of all-metal devices to release minute metal particles at the site where two components connect.

As this occurs, metal debris may accumulate in tissues and bones surrounding the implant, rendering recipients susceptible to pain, inflammation, and soft tissue damage. These metal ions may also be distributed through a patient’s bloodstream, bringing about systemic reactions or illnesses elsewhere in the body. Moreover, such adverse event may also cause a hip device to come loose, precipitating dislocation or even premature implant failure.

A large number of MoM hip implant recipients who may have undergone a revision surgery due to early hip device failure have started filing lawsuits against various hip replacement device makers in the US. Relevant information regarding these hip replacement lawsuits and other concerns involving hip replacement implants are also featured on some personal injury law firm sites.
Hip replacement surgery has reportedly emerged as one of the most commonly performed surgical procedures in the United States.  In fact, government statistics shows that it is carried out more than 300,000 times in the country each year.  Recognized as one of the most successful interventions in orthopedic medicine, hip replacement surgery has revolutionized the nature in which a severely damaged hip is treated, according to medical experts.

Also referred to as total hip replacement or total hip arthroplasty, hip replacement surgery is a procedure that entails the removal of a diseased or damaged hip joint, which is then subsequently replaced by an artificial hip device, as described by medical journals.  It is a surgical intervention frequently performed in individuals with severe cases of hip osteoarthritis -- a degenerative joint condition characterized by pain and stiffness, reduced range of motion, and decreased flexibility in the affected joints.  Other problems for which a patient may necessitate hip replacement surgery also include hip damage from serious injury or fractures, and other related conditions, such as septic arthritis, avascular necrosis, Paget’s disease of the bone, bone tumors, and hip dysplasia.

Over the last 10 years, significant improvements in the artificial bearing surfaces of hip implants have allowed different types of hip replacement implants to be utilized in patients during hip replacement surgery, medical experts say. These implants vary in composition and structure, with the conventional ones containing ceramic or plastic materials and newer devices comprising components made of various metal alloys. Designed to last longer than traditional hip devices, metal-on-metal hip implants with ball-and-socket junction have grown in popularity since they have been introduced by the medical device industry. Alongside their benefits, however, were mounting reports of device-related problems that have drawn a series of hip replacement lawsuits against major medical device companies.

Lawsuits highlighting hip replacement implant hazards have been brought in various courts throughout the US. Most of these cases claim that recipients had to undergo revision surgery to address the problems allegedly caused by their hip replacement implant. Added information about the dangers these medical devices have been reported to cause may also be found on various personal injury law firm sites, such as provided by the Rottenstein Law Group.
In its continuing series on the United States’ health care expenditures, the New York Times featured in a recent article the seemingly unrelenting costs that entail hip replacement surgeries in the country. Hip replacement surgery, one of the most commonly performed procedures in the US, turns out to be one of the most expensive treatments.

Hip replacement costs have reportedly shown a constant upsurge, rising by nearly 300 percent between 1998 and 2011. Moreover, implant pricing has not shown signs of descent and has even been reported to increase by more than five percent every year. With the skyrocketing cost of services, numerous patients have been reportedly left with no choice but to fly across continents to obtain such treatment.

This was reportedly the course of action taken by Michael Shoppen, a 67-year-old architectural photographer from Boulder, Colorado who flew to Belgium to have his arthritic hip addressed. He has been suffering from debilitating pain in the hip, preventing him from performing normal day-to-day tasks and making it impossible for him to even work. However, reports say his health insurance company would not cover his hip replacement procedure as his arthritic condition was related to a previous sports injury.

Shoppen’s surgical and recovery costs would have reached more than $70,000 had it been performed in the US, according to the New York Times article. At a hospital located in Torhout, Belgium, Shoppen was able to undergo the procedure and obtain a new joint for only $13,660. The overall price was also reportedly inclusive of operating room charges, assistive devices, medications, doctors’ fees, and round-trip airfare to the US.

Most American patients who travel to other countries for medical support are usually those without health insurance or those whose treatment may not be covered by their insurance company, online sources say. While many of these medical tourists used to fly to Asian countries, such as India or Thailand, to acquire cheaper health care, some have reportedly made Europe their medical destination, where service fees are only a mere fraction of what is charged in the US.