NY Times continues with their articles about failures...
How about a positive article about the overwhelming majority for a change?
http://www.nytimes.com/2011/10/01/health/01hip.html?_r=1&nl=todaysheadlines&emc=tha25
David,
I think the metal reaction is the one big scary unknown about Metal on Metal resurfacing.
You are right it is fine they publish stories about the possible problems, but what writting about the other 98% percent that have 5+ years of mobility and improved quality of life? Many of them right here on the this site.
But when you see this the number history in the article 5000 issues out of 500k done have the reaction that is 1%. My Doctor was very clear if you do get a reaction it is in the first 1-3 years and need to be aware of the symptoms.
Matt
The journalist had to search hard to find Dr. Young-Min Kwon, a surgeon that is not known, at least on this board, as a hip specialist.
We are all aware of the issues connected with metal on metal. I actually appreciated the article, because it reminds me to continue to be vigilant of my resurface. I'm on month 7 and have not had any major issues. I am gradually working myself back into shape and plan on starting a running workout next Spring. I don't want to become too complacent though. There are now pieces of metal in my body that were not there originally. That metal may very well have to come out one day and by then, I hope there will be better materials and procedures available to either replace or to resurface my hip. In the meantime, I'm continuing with my plan to get back to a healthy lifestyle, while staying watchful of myself and what's happening out there with research into metal hips and resurfacing.
Mac
Okay, I for one am very alarmed by this article, since I am ten times higher than the safe zone, which I just found out when my plasma results came back from Toronto, this Monday. It has been 4 1/2 years since my BHR, performed in Hong Kong by an Australian doctor.
I now live in Vancouver and the Toxicologist at the hospital says I am the second he has seen with high levels. The other person happens to be a doctor or surgeon at the hospital.
Anyone NOT concerned about this, with no disrespect intended, is foolish.
This site is absolutely fantastic, as long as it isn't run by Birmingham related doctors etc, and remains truthful.
I have great hope when reading all the excellent success stories, still for those of us with some problems, reading about those is important too.
Thank you for posting this
Having taken the time to read up on his background, I think one should be careful about questioning Dr Kwon's expertise in the field of problems relating to MOM hip arthroplasties. If you have the time, I am attaching a link which includes a video of a grand rounds presentation that he did on the research into soft tissue reactions with MOM bearings. It contains information that many of us are familiar with, but is very thorough.
http://achesandjoints.org/2011/01/19/young-min-kwon/ (http://achesandjoints.org/2011/01/19/young-min-kwon/)
Like all of us, I think we all keep an eye on this issue as a possibility, but not the norm. I probably will insist at some point that I have a test for metal levels, since it is a serious consideration. I feel for you, cwg and anyone who is dealing with this.
Thanks for posting the link. Balanced and objective presentation.
I just viewed the entire presentation by Dr. Kwon that John C had posted...
http://achesandjoints.org/2011/01/19/young-min-kwon/
I'm even more pissed off now at the NY Times story.
The failures that are noted are right in line with the current protocol for general hip resurfacing candidates. Please watch it for yourselves before initiating any new found panic. 5 out of the 6 affected were small boned women, blah, blah, blah. Same shit you and I already know.
Best...and riled...
David
John,
Thanks for posting Dr. Kwon's presentation. Very informative. My cup angle happens to be 32 degrees, which is just barely within his 40 degree, plus or minus 10 recommendation. I know no surgeon or device is perfect and I will continue to keep an eye on the research being done on MOM. In the meantime, if my other hip should need surgery (and I'm told it will in a couple of years), I would go ahead and get another hip resurface (and probably by the same surgeon), based on the information available today.
Mac
Metal on metal and ions are a viable issue for anyone considering surgery to research.
BUT, what is the alternative? If you are u der 40 yrs old.... Or even under 50... And you are in massive pain, and NEED hip surgery, whether you do THR or HR, What other implant is available now that could perform and LAST as long as a MOM implant?
I know they have tried plastic on metal, and there have been issues with plastic debris causing problems. Ceramic?
I researched the metal ion issue, but felt there wasn't much alternative to HR if I wanted to have surgery.
Good news doesn't sell newspapers
It is a long dialogue given by this Dr. Kwon, and I have just got round to listening to it. Dunno who else has. I am not sure if the journalist who wrote the article has listened to it, because his article does not show it. In fact, his article states 'but specialists like Dr. Kwon are also seeing growing numbers of patients with complications,' whereas the video dialogue, Dr. Kwon talks about the statistics from his research of other surgeons and registries.
In his dialogue, Dr. Kwon broadly says that pseudo-tumors arise from edge loading (there you go, 40 minutes condensed). And to counter this, there should be good choice of patients, proper placement and good choice of device. He seemed to think that choice of patient was the most important, but he did not say why that should be.
So I am still with the opinion that proper placement is the most important.
The New York Times must be hard up to have printed that article.
If you will notice, all of these negative articles have ONE thing in common. The Author, Barry Meier. I have personal experience with the guy. He ONLY reports and write HALF truths and leaves out very important facts. He is KNOWN for this and has at least a half a dozen of these articles over the years that all leave out the most important info, anything pointing to the real reason behind the failures, surgeon error, or malpositioned components. I have learned to pretty much ignore anything that Barry Meier writes now. I even address him personally now on my website, at first I had a certain writer of the NYT, but now I have had enough of him so I recently changed it and put his name. He interviewed me for over an hour for his first article and left out most of what I said and ONLY put in the negative. He promised me he would be unbiased and write both sides and asked me for the name and contact of one female with a femoral neck fracture and one female with a success story. So I sent him Kathy Bird's info which he wrote about in length in his Women and Red Flags article about resurfacing being bad for women and guess what? He NEVER even contacted the gal I sent him the info for that had her BHR for 12 years and was running and back to living life fully and super happy. Never even tried to email or call her. The guy is a joke! Anytime you see another article in the NYT, just look to see if the author is Barry Meier.
Vicky Marlow
I think most of the top resurfacing surgeons regularly test their patients for metal ions. My friend who had this surgery 7 years ago (and referred me to Dr. Gross), had one of her follow up appointments with Dr. Gross about a month ago. She is a small boned, extremely active female. No metal ion problem. I agree with so many of the previous posts - get the facts, make the best decision you can, pick a very good surgeon, and then keep an eye on things. There is no joint replacement surgery of any kind that is 100% risk free!
CWG - what will you do when the THR stem starts warbling out of it's socket because you ran too much on it?
Nothing's perfect, so who do these guys work for? Kwon's presentation seemed a touch spun to me. I've read a bunch of papers and it's all the same hype which is based on about the 2% to 4% revision population. As Lop points, it's based on sugeon error and placement. Why aren't the journalists writing about all the failed THRs in young people, how about in the older people for that matter. Oh that's right, I forgot, House MD had a show MoM failure, it must be right then.
The new history of MoM issues (summarized below and obviously simplified), starts in August of 2010
ASR has problem
frothing attorneys jump on a class action lawsuit
a bunch articles come out about it
CBS has a show on House MD about it (Feb 2011)
FDA asks for more data on MoM athroplasty, but not due to ASR, due to the MoMs getting approved in the 1970s before the newer rigorous methods were in place, they just need more data
NY Times has a few exciting articles on the topic
here are today and people are getting scared away from MoM HR.
Hey, So I am new in here. just found it the other day. I am scheduled for resurfacing on Monday9/10.
After years of exercise, training "alternative" remedies etc etc. Long time with pain and trying to work it out.
Found out last year That I am bone on bone with spurs and I actually ground a little extra in my socket. I cycle 20 miles a day an do posture alignment therapy. So.. It has become too much to manage. I am 42 with small children. Finally worked through all the mental blockades and feel complete that I have done everything I can for myself.. Ready to go.. This article Freaked me out. Set me way back. Anyone have this procedure done more than 5 years ago? I've read some positives and share similar goals with some of you. I know what media is all about. At the same time my confidence level has dropped. I know a full replacement is not for me right now. I am just hoping this will last more than 3 years. I'm also reading people monitoring the situation. Is that constant blood work? How will we know if it has gone too far. I am guessing most of you, like me, have a great tolerance for pain. will a little pain be too far??? I would love input from a long time resurface. Please.
Jason, before my surgery, my surgeon said I had a ninety nine percent chance of it lasting ten years (as his success rate is 99%, higher than many surgeons). I said that was not good enough, I want fifty years.
And I still do. I can only see that a good device placed by a top surgeon should last indefinitely.
D.
Wow- JASON, don't know what to say.. except I think I really did not, 1000%, need a hip surgery of any kind, performed. Sounds like you do.
I lived in Hong Kong and "optional" surgery is rampant.
Never did I hear 'you MUST have something done'. I had pain and problems, yes, but hindsight shows me I have problems through out my spine (cervical stenosis etc) None of them materialized until after. Immediatly after.
In my humble opinion, and with metal levels 10 times the "recommended", I still think you should go through your surgery.. and with confidence.
I now believe I was not a 'good candidate'. My fault and responsibility
You have exhausted everything. Move forward with certainty (positive attitude).
Breakaleg as they say in my work world
Jason, I'm not personally a long term resurface, but the lady who referred me to Dr. Gross had her surgery 7 years ago. She is an extremely active female, and had a follow up appointment with the doctor about a month ago. He checked the placement of her devise, was very happy with it, and tested her for metal ions. There was no problem.
Go for it with the best, most experienced surgeon you can find!
I'll add a little more to Vicky's posts.
Mr. Cartier said, adding that he learned of Dr. Kwon while researching metal hip problems on the Internet
How hard can it be to find Hip Talk and Surfacehippy and read a little to find out who the number one surgeons are?, it's not hard, its rather easy.
Food and Drug Administration received more than 5,000 reports about problems with the all-metal hips,
If you divide that by 500,000 (presented earlier in the article) you get about 1%, which is less than the 2% to 4% that we see in the papers written by the experienced suregons. 1% is pretty good. Sure that's only for the 7 maybe 10 yrs that this has been tracked, but it's not that alarming.
he took the trip to Boston to see Dr. Kwon. In 2007, from Manchester NH? (presented earlier in the article in reference to the patient) What is that like 50 miles? If you want it done right you should expect to potentially travel to places like Belgium, New York, South Carolina, India, Birmingham UK, Seattle, LA, Boulder,...
which was made by Stryker I didn't know Stryker made an HR device.
“He was the trouble guy,†Mr. Cartier said. “He deals with the cases that other people couldn’t figure out.â€
I think Dr. Gross is the trouble guy, maybe Su, De Smet, Pritchett,... I've never heard of Kwon until this article.
learned last year that the model of artificial hip she got in 2007 was being recalled by its manufacturer, the DePuy division of Johnson & Johnson, because of its high early failure rate. I think it's a little unfair to include the ASR recall model in with the other models where metallosis has been attributed to poor placement, not device design.
Tissue damage is also occurring in some patients with low or normal metal blood levels and in some patients who are free of symptoms. I haven't seen any papers suggesting this. Actually it sounds like it's the other way around. Pain and discomfort presents first and then you see elevated metals. If caught early, because of obvious pain and discomfort with subsequent metals analysis, revisions have been succesful.
“He told me, ‘I can’t guarantee that you are going to be one of those guys who come out as well as you went in,’ †he said. What are you talking about? None of us went in well, we were in pain and our ROM sucked, we tripped on sidewalks, couldn't sleep, took narcotics, barked at our families,.... OK, go ahead, if you really want to, you can lop off my femur and throw a THR are in there, I really don't care, I just want to get my life back.
Quote from: Tin Soldier on October 05, 2011, 12:31:46 AM
Tissue damage is also occurring in some patients with low or normal metal blood levels and in some patients who are free of symptoms. I haven't seen any papers suggesting this. Actually it sounds like it's the other way around. Pain and discomfort presents first and then you see elevated metals. If caught early, because of obvious pain and discomfort with subsequent metals analysis, revisions have been succesful.
I have to pick up on this claim Tin. I had no pain or discomfort but my metal levels were sky high and increasing rapidly. Not only was there tissue damage but a range of other serious side effects.
And while I am at it, I know everyone wants to be reassured by saying that it is only the badly placed components that have problems, but again that simply was not true for me. My inclination angle was 40 degrees.
Hey JMS- Oye, I appreciate you here. Very much.
My levels are high, not as high as yours, only ten times. Yours were much higher.
My xray seems to look like it is in place (original records are still in Hong Kong, where I lived for 18 years)
My pain is not only in the hip, it is random. So, not specific.
The one thing that is with me, on and off, but frequent enough, is I feel unwell. Bit nauseous, wobbly, and lately, a weird taste in my mouth and a furry/rough feeling on the back of my tongue.
And a dry mouth, especially during the night, probably from my new sleep apnea symptoms, the last couple of years.
Did you feel unwell? The other nonsense is probably unrelated (taste, tongue apnea etc)
Have to add, my life is very very good otherwise
Thanks for your input here!
JMS - good point about your situation. I was slightly inflammed about the article and so my scale was tipped the opposite direction of the journalist. Obviously journalism these days tend to be on the dramatic side. I guess with that particular comment about the tissue, it makes it sound like all of us with no pain, no discomfort, no signs of metallosis have sleeping dragons within our hips and we'll all be looking at major tissue necrosis, chronic heavy metal toxicity throughout our bodies, and a difficult revison to THR sometime on our future. The papers and the experienced surgeons are not saying that. They are saying after 7 to 10 years of data, 2% to 4% have metallosis and they also say that metallosis, if it is going to show up, generally shows up on the early side of that 7 to 10 year period.
Hi Tin,
I know where you are coming from re the journalistic scare techniques. And to be fair, I should point out that I was not totally asymptomatic. It's true that I was free of any pain and discomfort, but I was clunking constantly. That's what eventually triggered the metal testing. So, no, people who are truly asymptomatic don't need to fear the sleeping dragon, I don't think.
Argh, I said I'd only sit back and read... but I clunk all the time!
Audibly, to others close enough... (trainers PT etc)
anyway
Is the clunking increasing?