• When Pain After Hip Replacement Surgery Does Not Subside
  • November 10, 2014 | Author: Wendy R. Fleishman
  • Law Firm: Lieff, Cabraser, Heimann & Bernstein, LLP - San Francisco Office
  • After hip replacement surgery, most patients spend 3 to 5 days in the hospital, according to the National Institutes of Health. Full recovery from the surgery takes about 3 to 6 months, depending on the type of surgery, overall patient health, and the success of rehabilitation.

    Pain is an inevitable fact in the wake of hip replacement surgery. Health authorities recommend that patients manage their post-operative pain as best they can. Pain control maximizes a patient's ability to participate in therapy and recover as quickly as possible.

    Some patients do worry about pain medication -- will I become addicted? Will it stop working? The U.S. Food and Drug Administration notes these worries are most often unfounded, and that proper and careful medication of post-implantation pain is a critical part of the healing process.

    Many types of medicines are available to help control pain, including opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and local anesthetics. The American Academy of Orthopedic Surgeons notes that alternative approaches, such as medical hypnosis and acupuncture, are being used more often as surgeons and their patients increasingly choose such methods to supplement conventional medicine.

    Beyond Normal Pain: Defective Hip Implant Devices and Injuries

    Unfortunately, complications can occur that prolong the pain, and complicate a patient's recovery after hip replacement surgery.

    While many factors can affect ongoing pain, one factor over the past several years has resulted in tens of thousands of Americans experiencing prolonged pain after hip replacement surgery: that the patient received an all-metal or partial metal hip implant.

    The U.S. Food and Drug Administration has stated that there are "unique risks" with metal-on-metal artificial hips. Friction from metal parts of the implant rubbing together can release small metal particles into the surrounding tissue and bloodstream. As metallic debris accumulates in the patient, it can trigger metallosis, which is a painful, inflammatory reaction to the hip implant.

    Patients who received metal hip implants should be aware of the symptoms of a defective metal hip implant. Common symptoms may include:

    • Pain in the groin, hip or leg
    • Swelling at or near the hip joint
    • Squeaking in the hip joint
    • A limp or change in walking ability

    For example, the DePuy Orthopaedics ASR XL Acetabular and ASR Hip Resurfacing system hip are all-metal, also called metal-on-metal, artificial hip implants. Nearly 40,000 patients in the U.S. received the DePuy ASR implant from August 2005 through August 2010, when DePuy, a unit of Johnson & Johnson, recalled the devices. DePuy also manufactured metal-on-metal hip implants from 2002 to 2012, sold under the brand name Pinnacle hip, with a metal liner (called the Ultamet metal liner). In many patients, the metal-on-metal version of the Pinnacle hip implant has failed. DePuy withdrew its Pinnacle hip replacement implant from the market in 2012.

    A large percentage of patients who received the DePuy ASR and Pinnacle metal hip implants experience pain and complications from the devices. It is estimated that over 50% of all DePuy ASR implants will fail within six years of their implantation, a percentage far greater than that seen with ceramic or plastic artificial hip implants.

    Similarly, in June 2012, Stryker Corporation recalled its Rejuvenate Modular and ABG II modular-neck hip systems due to "fretting and/or corrosion" in the implants which may lead to an "adverse local tissue reaction, as well as possible pain and/or swelling, in or around your hip." Stryker began selling its Rejuvenate hip implant in 2009 and the ABG II hip implant in 2010.

    Stryker's Rejuvenate and ABG II modular-neck hip stem systems are not considered metal-on-metal devices, since they do not have a metal ball that rubs against a metal socket. However, the Stryker Rejuvenate and ABG II device necks are made of chromium and cobalt, and the stems are coated with titanium. As a result, these devices have metal-on-metal junctions. The Stryker hip implants failed in many patients due to metallic debris being released into nearby tissue and the blood stream.