Risk for Osteoarthritis Increases with Obesity
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The factors that may bring about the development of osteoarthritis are many, health experts say, and one of them is weight. It is important to maintain an ideal body weight because the weight of a person increases the increases of having osteoarthritis, according to the University of Washington Orthopaedics and Sports Medicine. Those who are overweight may experience more health problems compared to men and women who have a normal body mass index. Men and women with such conditions may also avoid physical activities because the weight of their body gets in the way, which causes the joint problem to worsen.


Osteoarthritis may be more common among elderly individuals but it usually starts as early as 40 years old. Our body weight is being supported by the joints in the knees and hips, hence, they are known as the weight-bearing joints. The joints are under more pressure if the person is obese or overweight, especially when it is being used. High impact activities are not advisable because the stress applied to the hip joints is doubled. Having those extra pounds not only contributes to the cause of the problem but also its progression. The lining that protects the joint is also lost.


Walking, standing or twisting often makes the pain worse. If left untreated, the osteoarthritis will not only bring pain but also joint stiffening and deformity. The stiffening of the joint may cause immobility and more pain. Hence, health care providers advise patients to lose weight if they are still able to before the disease progresses to a more serious problem as the pain and stiffness might prevent the individual from exercising.


Some treatments help in easing the symptoms and delay the progression but osteoarthritis is still incurable. Having a family history of any form of arthritis may put the person at higher risk of having this problem, thus they need be mindful of their joints. Avoiding trauma to the joints while maintaining an ideal body weight may reduce the chances of having problems with the joints. If the symptoms are not lessened, the patient might opt for hip replacement operation. It may help to visit the Hip Recall News Center for more information.



URL References:
orthop.washington.edu/?q=patient-care/articles/hip/osteoarthritis-of-the-hip-hip-arthritis.html
dukehealth.org/orthopaedics/services/hip-treatments/care-guides/hip-arthritis
arthritisvic.org.au/Conditions-and-Symptoms/Osteoarthritis-of-the-Hip-and-Knee
niams.nih.gov/health_Info/Bone/Bone_Health/Exercise/default.asp

Potential Risks Involving Hip Replacement Surgery
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Many people undergo hip replacement surgery all around the globe. Implants used in these hip surgeries can either be made of plastic, ceramic, or metal. Among the hip designs out in the market, however, hip producers assure the public that metal-on-metal (MoM) hip devices are unsurpassed in terms of durability and range of motion. Nonetheless, various health regulators have questioned the safety of such hip implants.


As hip replacement grows in popularity, reports of complications linked to the devices used in the surgeries have surfaced. Based on reports, one out of ten hip replacement patients encounter some form of complication after their surgery. Frequently reported problems of hip replacement are listed below:

Loosening of the hip device – When the bone around the hip replacement device declines, this may occur. Moreover, this problem may also arise if the shaft of the hip device loosens in the hollow of the thigh bone. This adverse effect commonly occurs 10 to 15 years after hip replacement.

Dislocation of the hip joint – Statistics show that hip implants come out of their sockets in one out of twenty hip replacement cases. This problem commonly happens months after the procedure, at which time the hip will still be in the process of recovering.


Along with the above common complications, there have been reports of severe adverse effects associated with MoM hip devices. Below is a list of some major adverse effects related to hip replacement:

Blood clots – This complication may potentially transpire a couple of weeks after hip replacement surgery. The clots may either develop within a major vein in the implant patients’ leg, or in their lungs. Medical experts identify the clot formation in the leg of patients as deep vein thrombosis, and the clot formation inside the lung as pulmonary embolism. Both medical conditions can have devastating results.

Infection – Infection may potentially occur once germs reach the tissue surrounding the hip device.


Medical Manufacturing Companies Recall Hip Devices after Reported Complications Surfaced

More than a few prestigious firms have recalled their hip replacement systems over the years. One such company is Johnson & Johnson’s orthopedic division, DePuy Orthopaedics.

The firm recalled its MoM ASR XL Acetabular and hip resurfacing systems after an increasing number of adverse effect reports surfaced. Most recalled hip replacement systems, incidentally, are MoM.



nhs.uk/Conditions/Hip-replacement/Pages/Complications.aspx
mayoclinic.org/tests-procedures/hip-replacement-surgery/basics/risks/PRC-20019151


A Brief History of Some MoM Hip Recalls
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The number of patients developing complications following metal-on-metal (MoM) hip replacement surgery has significantly increased in recent years, according to various medical research studies. Moreover, these studies indicate that up to three percent of implant patients with MoM hip devices require revision surgery due to difficulties caused by complications associated with the implants. Apparently, the risk is so high that even the Mayo Clinic reportedly reduced its usage of such hip devices by 80 percent last year. The high revision rate has also raised the concerns of medical experts and federal health regulators all over the United States and abroad.


Over the years, a number of companies that manufacture MoM hip replacement devices have recalled their hip systems due to reports of complications, online sources say. In fact, even MoM hip devices made by well-known medical firms, such as Johnson & Johnson, are reportedly plagued with problems. Other companies involved in MoM hip production include Stryker, Biomet, Wright, and Smith & Nephew.


Stryker’s Rejuvenate and ABG II Modular Hip Replacement System Recall in 2012

In June 2012, Stryker Orthopaedics recalled two of its popular hip devices known as the Rejuvenate and ABG II Modular hip replacement systems. Both hip devices were supposed to be the upgraded versions of traditional MoM implants, able to last for more than 15 years. Unfortunately, just like their predecessors, the devices apparently demonstrated high failure rates, based on online media reports. Thus, Stryker voluntarily recalled the hip devices.


Smith & Nephew's R3 Hip Replacement System Recall in 2012

Smith & Nephew issued a voluntary recall of its R3 Acetabular hip replacement device in June 2012. The device was reported to have a defective metal liner that caused serious injuries in implant patients. This has allegedly resulted in several hip revision surgeries.


DePuy Orthopaedics' ASR XL Acetabular Hip Replacement System Recall in 2010

Despite its positive reputation, Johnson & Johnson's orthopedic division, DePuy, issued a product recall of its ASR XL Acetabular System due to reports of complications. Aside from the Acetabular hip replacement system, the company also recalled its ASR Hip Resurfacing System. The recall for both devices was issued in August 2010. DePuy reportedly suffered huge financial loss associated with the recall.



http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2739467/
http://safepatientproject.org/wordpress/wp-content/uploads/2013/09/Hip-Recalls-Summary-Final-9-9-131.pdf
http://en.wikipedia.org/wiki/Hip_replacement#cite_ref-14


FDA Cites Problems on MoM Hip Implants
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Health problems related to the use of Metal-on-Metal hip devices are commonly reported by patients since it was introduced as few years back, medical news reports say, which prompted to have a review of these prostheses. The Food and Drug also gathered several resources from various international orthopedic implant registries, medical professionals and researchers before conducting their own review and releasing the medical device alert for this type of implants. The high failure rate of hip replacement operations using the MoM devices was increasing based on the data from the national joint registries, according to the American Association of Orthopedic Surgeons (AAOS). The Ministry of Health in India also released a warning related to the use of DePuy ASR among patients.

Complications arise from DePuy's metal on metal hip implants

The FDA has identified the following problems that may be caused by the MoM hip device:

-      Systemic symptoms – these adverse effects may be attributed to the metal ions that are released by the prosthesis in surrounding tissues and in the bloodstream. There are several symptoms that may be experienced by patients such as:

o   General hypersensitivity reactions – rash may appear in different areas of the skin.

o   Renal function impairment – difficulty voiding and other renal problems.

o   Changes in psychological status – some have developed depression after they were implanted with the hip prosthesis.

o   Cardiomyopathy – a disease affecting the heart muscles which may cause the muscles to become enlarged, thick or rigid. It may lead to heart weakness.

o   Thyroid dysfunction – problems in the thyroid that may lead to feeling cold, fatigue, neck discomfort or weight gain.

o   Neurological changes – they may experience various changes in their neurological status and sensory problems such as auditory and visual impairments.

-      Hip implant failure – the failure of the implant may have been due to the adverse local tissue reaction (ALTR) caused by the deposits of metal particles in the tissues surrounding the prosthesis. Metal particles are released by the implant as the patient use the implant. This may lead to the following symptoms:

o   Pain – localized in the groin or hip.

o   Swelling and numbness – the hip may look swollen and feel numb.

o   Gait problems – difficulty in walking due to pain or swelling

o   Sound coming from the hip – a popping, clicking or squeaking sound may be heard.


These health problems enumerated by the FDA are communicated to patients and health care providers alike. Several patients who have heard about the DePuy hip recall have filed charges against the manufacturer of the implant.




URL References:
fda.gov/medicaldevices/safety/alertsandnotices/ucm335775.htm
aaos.org/about/papers/advistmt/1035.asp

Are there any Possible Alternatives to Hip Replacement Operation?
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The complications associated with the hip replacement operation makes it hard for most people to undergo the said operation, health experts say, especially when there are other conservative treatments to choose from. The artificial ball and socket that replaced the natural joint is much smaller, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), hence the hip implant is prone to dislocations. Trying other treatments instead of going under the knife was a more viable option for some people who are experiencing debilitating hip pain. A simple lifestyle change to difficult surgical procedures are some of the options for easing hip pain.

risky-depuy-asr-hip-replacement-surgery1

Patients with hip pain are recommended to follow lifestyle changes as the first option in alleviating hip pain. Easing mild to moderate joint pain may be done through the aid of exercises, rest, weight loss, dietary changes, and walking aids as these will ease the pressure on the joints. The added weight gives more pressure to the problematic joint, hence, dietary changes and weight reduction will help. A temporary way to decrease the pain may be felt with using a warm and cold compress. Those who do not have severe hip pain and damage may experience relief from following these lifestyle changes but it does not apply to other individuals with severe joint problems.


Medications may be prescribed by health care providers if the pain does not lessen with non-pharmacologic approaches. An inflammation may lead to the prescription of non-steroidal anti-inflammatory drugs (NSAIDs). If there is no sign of inflammation, one may be prescribed with acetaminophen. If the patient is not responding well to lower doses, they might be given stronger analgesics. However, using these drugs also has its own set of side effects that needed to be reported immediately to the attending physician. Using these medications in the long run might cause more problems, so these drugs need to be used carefully.


If the non-surgical approaches are not able to deliver the intended results, then orthopedic specialists may suggest other means to eliminate the discomfort. If one still does not want to have a hip replacement surgery, then an osteotomy might be a viable option. The diseased portion of the joint is cut and realigned, although the patients will need more time to heal. Choosing to find other options for treatment of hip pain is open for all men and women. Patients who choose to undergo the hip replacement surgery may be warned of the possible complications and the hip replacement recall.



URL References:
niams.nih.gov/Health_Info/Hip_Replacement/#3
nhs.uk/Conditions/Hip-replacement/Pages/Alternatives.aspx
nytimes.com/health/guides/disease/osteoarthritis/lifestyle-changes.html


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