As researchers scramble to assess the health dangers of flawed artificial hips, the federal government has received a flood of new complaints about the devices.
An analysis by The New York Times reveals that the Food and Drug Administration has been deluged with more than 5,000 reports since January about several types of so-called metal-on-metal hips. That is more than the overall complaint total for artificial hips for the previous four years. Most are from patients who either had, or will have, the devices removed because they failed long before their expected duration of at least 15 years.
The growing number of complaints raises the likelihood that all-metal replacement hips will become the most expensive medical implant problem in several years, the biggest since the 2007 Medtronic recall of a widely used heart device.
The hip implants, which have an artificial ball and cup both made of metal, tend to shed tiny particles of cobalt and chromium as they wear, causing crippling pain in some patients. Researchers still are struggling to understand the tissue damage caused by the debris.
Hip replacement is one of the most common medical procedures in the U.S. and, according to one estimate, roughly 500,000 patients have the all-metal implants. Amid the mounting complaints, however, most surgeons have switched to replacements that combine metal and plastic components.
“It is like playing Russian roulette,” said Dr. Geoffrey H. Westrich, an orthopedic surgeon at the Hospital for Special Surgery in New York, who no longer uses all-metal implants.
One of the most troubling devices has been the A.S.R., or Articular Surface Replacement. Recalled last year by Johnson & Johnson, it accounted for 75 percent of the complaints reviewed by the Times.
Under FDA rules, many all-metal devices were sold without testing on patients or a means of tracking their performance. In May the FDA took the unusual step of ordering producers to study the devices’ failure rate and health risks, but the companies have faced obstacles in conducting sound studies.
For many patients, any changes will come too late. In 2008, Ann Morrison, a 50-year-old physical therapist from Newark, Del., received all-metal replacements for both of her hips and soon experienced pain, rashes and inflammation.
Morrison had the devices replaced last year, but by then the metal debris had caused so much tissue damage that she now needs a brace to walk. She called the FDA’s order for medical studies a “joke.”
“We will be the little crash test dummies here until they figure out the health ramifications for us down the road,” said Morrison, who has sued the DePuy division of Johnson & Johnson, the manufacturer.