No surgical implant lasts forever. In recent years, however, orthopedic specialists have become increasingly concerned about the damage one type may do as it wears down.
An article in the Sept. 30 New York Times describes the grim situations that some total hip arthroplasty patients have found themselves in as their metal-on-metal implants have failed and inflicted musculoskeletal damage as they did.
"More than a decade ago, some researchers had warned that the hips shed tiny pieces of metallic debris that posed potential health threats to patients," says the report. "But those warnings were not heeded, and now doctors and patients face a growing public health problem as one of the country's biggest medical device failures unfolds."
The metal fragments are not always detectable through blood tests or diagnostic scans, the report says. Their harmful effects on tissue, muscle and bone are not always recognized by physicians before permanent damage occurs. Patients suffering from failed implants and their complications don't even show consistent pain or other symptoms.
In May 2011, the Food and Drug Administration ordered 20 implant manufacturers to undertake studies of their all-metal hips to determine their failure rates and the impact failure would have on patients.
David Bernard
