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Depuy Hip Replacement for a Medical Social Workers Perspective

According to the DePuy Hip Replacement Helpline ,MSW, who has worked as an administrator in geriatric rehabilitation for 12 years,” the faulty hip replacements have a huge effect on our over 65 community,”

According to  our Medical  MSW,” these faulty hip replacements affect seniors at a time in their lives when quality of life and independence are crucial factors” “Any surgery takes longer to recover from and having to go thru it twice is very difficult for our seniors”The psychological and physical effects put seniors back months”. ” Having to go through additional pain and surgeries can lead to severe depression and a downhill process” “People are now afraid to get hip replacements due to all the bad publicity. “This affects their independence and future health and mobility”
In the months since a recall of the DePuy ASR XL artificial hip, DePuy might be facing the recall of yet another one of its hip replacements, the Pinnacle Acetabular Component, which has been facing increased scrutiny for its premature failures.
Like the ASR XL, the Depuy Pinnacle is a metal on metal system that was designed to last at least 10-15 years but now, orthopedic surgeons are reporting that these devices have been failing within one to two years of being implanted into their patients.doctors in England are now reporting that 49 percent of DePuy ASR XL hip implants have failed after six years. This is a sharp increase in failures since seven months ago when DePuy recalled the hip implants because the failure rate was 12 percent
That’s not good news for DePuy, a division of Johnson & Johnson, which has implanted over 150,000 Pinnacle hip replacements into patients since it was put into service in 2001. Its recent recall of the defective ASR metal-on-metal hip implant systems has forced thousands of hip implant patients to have additional, painful and expensive hip revision surgeries. This effects seniors the most. All surgeries at that age are traumatic with extensive recovery time and rehabilitation. After the surgery, the patient, can spend weeks in a rehabilitation facility away from family, friends and routine.According to physiciansYou will be allowed only limited movement immediately after hip replacement surgery. When you are in bed, pillows or a special device are usually used to brace the hip in the correct position. You may receive fluids through an intravenous tube to replace fluids lost during surgery. There also may be a tube located near the incision to drain fluid, and a type of tube called a catheter may be used to drain urine until you are able to use the bathroom. The doctor will prescribe medicine for pain or discomfort.

On the day after surgery or sometimes on the day of surgery, therapists will teach you exercises to improve recovery. A respiratory therapist may ask you to breathe deeply, cough, or blow into a simple device that measures lung capacity. These exercises reduce the collection of fluid in the lungs after surgery.

As early as 1 to 2 days after surgery, you may be able to sit on the edge of the bed, stand, and even walk with assistance.

While you are still in the hospital, a physical therapist may teach you exercises such as contracting and relaxing certain muscles, which can strengthen the hip. Because the new, artificial hip has a more limited range of movement than a natural, healthy hip, the physical therapist also will teach you the proper techniques for simple activities of daily living, such as bending and sitting, to prevent injury to your new hip.

This isolation can effect mood. After discharge there is usually weeks of in home rehabilitation.Exercise becomes significantly more important as we age for strength and balance. These surgeries,with recuperation time, less weight bearing, and reliance on others effects individuals over the age of 65 much more then a younger ,more active person.Many people think that beyond a certain age, you become too weak to strength train or benefit from it. But research shows the complete opposite. Without adequate muscle exercise, most adults lose 20 to 40 percent of the muscle they had as young adults. With too much muscle loss people have difficulties performing daily activities that allow them to live independently. Usually, people do not spend more than 3 to 5 days in the hospital after hip replacement surgery. Full recovery from the surgery takes about 3 to 6 months, depending on your overall health, the age at which this occurs, and the success of your rehabilitation.Going through this once, according to Spitzer, is traumatic, “We do not know how many seniors can actually go through this twice and regain the pre -surgery level of functioning”. Social Workers feel  this will not only affect an individuals quality of life but perhaps even life span ,depending on age and other health factors. If a senior
has kept going, for instance, by play golf every day with friends and he or she loses this ,it could be a downhill road. You may contact the helpline by calling 1 877-522-2123
Although the ASR and Pinnacle are both metal on metal systems, there are significant differences between the two insofar as:
* the ASR is a monoblock design whereas the Pinnacle uses a modular system.
* the ASR cup is made of one solid piece of metal whereas the Pinnacle has an outer shell
* The Pinnacle is designed in such a way that the surgeon has the option to place a metal, ceramic or polyethylene liner inside the metal outer cup
Much of the problem seems to be with the Pinnacle 36 mm Ultamet Metal-on-Metal component which is failing at an unacceptably high rate. One of the theories seeking to determine the cause suggests that a design problem flows from the fact that the device has been created with one of the lowest clearance levels in the industry. The only other implant with a clearance level this low is the DePuy ASR.
Attorneys and experts investigating the basis for the high rate of failure point to the product design and believe that DePuy created a very narrow window for proper placement of the prosthesis and inadequately trained surgeons in the proper implantation technique.
Like, the recalled DePuy ASR system, the Pinnacle was permitted to reach the market under the U.S. Food and Drug Administration’s (FDA) controversial 510(k) approval process, which allows a medical device to be placed on the market without being subjected to necessary clinical trials as long as the manufacturer can show that the device is “substantially equivalent” to a device already approved on the market. DePuy’s ASR system avoided obligatory clinical trials by showing that it was fundamentally similar to the DePuy Pinnacle hip replacement system, raising some serious issues.
Recently, the FDA has received hundreds of complaints and adverse incident reports against the Pinnacle system, attributed mostly to the Pinnacle’s propensity to prematurely separate from the bone. Moreover, like many other metal on metal devices, constant friction in the Pinnacle may cause an increased risk of metallosis, i.e. the release of miniscule metal particles into the surrounding soft tissue or bloodstream.
All of this has resulted in a wave of new lawsuits being filed around the country against DePuy. Just last week, a motion was filed in the United States District Court in California seeking to consolidate all DePuy Pinnacle cases before one judge in what is known as a multi- district litigation, or MDL. The MDL Panel is scheduled to rule on this application in May.
In the interim, the helpline and its hip replacement team continue to investigate claims of Pinnacle failures and counsel our clients on what to do in the event that they need revision surgery.

If you or a loved one have been implanted with a DePuy Pinnacle hip replacement and are experiencing any pain or disability:
-See a doctor immediately.
-Do not release any of your confidential medical information to any DePuy representatives before speaking to experienced hip replacement counsel.
-If you are told that you will need hip revision surgery, make sure that the removed component parts are preserved. Your counsel should be familiar with this process and be working with the proper experts to insure that it is done correctly.
We have huge concerns about the number of recalls and the new
replacements that keep getting added to the list. This effects our huge aging population. Individuals over the age of 60 and , more so ,70 are effected. individuals with numerous falls and hip fractures are candidates as well. This could effect a huge population by the time all the information comes out” ” From a social work perspective” says Spitzer this is very serious.
The Depuy Hip Replacement Helpline assists individuals in getting legal advice.
The helpline can be reached at 1 877 522 – 2123