New Research Reveals Ultrasound Useful for Detecting Pseudotumors in Metal-on-Metal Hip Device Patients

Researchers at the Hip Society Specialty Day Meeting in Chicago presented findings from a prospective study revealing that using ultrasound may assist in the diagnosis of pseudotumors in asymptomatic patients implanted with metal-on-metal hip implant devices.

On April 17th, Orthopedics Today reported that Dr. Donald S. Garbuz and his team discovered that ultrasound is helpful for diagnosing pseudotumors in asymptomatic patients who have been implanted with large head metal-on-metal hip implants. Dr. Garbuz and his team won the Hip Society’s John Charnley Award for their research.

According to a prior report in the journal, Orthopedics Today, researchers analyzed 40 patients with metal-on-metal hip implants who underwent both ultrasound and metal artifact reduction sequence (MARS) MRIs. “Both tests, ultrasound and metal-reduction MRI, performed well for the detection of pseudotumors. However for screening or initial diagnosis, I would say to you that ultrasound in an experienced ultrasonographer’s hand would be the preferred method due to its 100 percent sensitivity and lower cost,” said Dr. Garbuz, Orthopedics Today reported.

Metal-on-metal hip implants have long raised safety concerns in response to reports that the devices lead to early failure and other complications by releasing metal ions into the patient’s bloodstream and surrounding tissue. In 2010, Johnson & Johnson (J&J) recalled 93,000 DePuy Orthopaedics’ ASR metal-on-metal hip implants because of a high revision rate. J&J and its subsidiary DePuy face over 10,000 lawsuits alleging injuries from the hip device, Bloomberg News said.

We’ve repeatedly written that research has linked metal-on-metal hip implant devices, such as the DePuy ASR, to a number of adverse events such as tissue necrosis, pain at the implant site that sometimes spreads to the groin and back, inflammation, swelling, metal poisoning, high failure rates, osteolysis (bone loss), and fluid collection/solid masses around the hip joint. The issue appears to be with the metal used in the construction of the implants, which was touted to last for at least two decades. More and more, reports and research indicate that some patients have required painful revision surgeries just two or three years after original implantation.

This January, the U.S. Food and Drug Administration (FDA) issued new warnings about metal-on-metal hip implants, warning that the release of metallic debris can lead to bone or soft tissue damage. The agency also recommended diagnostic imaging such as CT, MARS MRI, and ultrasound be performed in some symptomatic patients.

“These findings are helpful for patients with metal-on-metal hip implants,” said Daniel C. Burke, Senior Litigation Counsel at national law firm, Parker Waichman LLP. “There are numerous lawsuits alleging that an all-metal hip replacement caused pseudotumors and other serious complications.” Mr. Burke said that the alleged flaws of the DePuy ASR are a prime example of why metal-on-metal hip implants are dangerous as a class of medical devices.

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