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In Your Healthy today, we'll learn about two common surgical procedures that are causing rare but serious problems. First, hip replacements. This month the FDA asked manufacturers of metal on metal artificial hips to find out how their patients are doing up to eight years after surgery. Some of the hips have not lasted as long as expected. And in very rare cases they've broken down and caused damage. NPR's Patti Neighmond has more.
RICK DOUGLAS: (Unintelligible)
(SOUNDBITE OF DOG BARKING)
PATTI NEIGHMOND: Rick Douglas loves being with his dog, Prissy Ray, a 14-year- old Yorkshire terrier.
DOUGLAS: She loves to walk the trails and climb the rocks and everything up in the mountains.
NEIGHMOND: But Douglas can't walk his dog anymore.
DOUGLAS: I take her to the park. My friend walks the dog while I sit in the car, wait on them.
NEIGHMOND: Douglas can't work at his old job either. He was a supervisor at Wal-Mart, which required racing from aisle to aisle in the store. That's physically impossible for him now. He's in too much pain, and he can hardly put pressure on his right leg. It all started about five years ago, when Douglas got an all-metal artificial hip, intended to relieve arthritic pain. But it caused problems right away.
DOUGLAS: It kind of felt like a grinding - like metal to metal grinding inside, constant pain, burning in the side of my leg. And that's why I kept going back to the doctor.
NEIGHMOND: Eventually a specialist determined the implant should be removed and replaced. During surgery there were some grim findings.
DOUGLAS: Metal shavings had come off of the implant and went into the tissues around the hip and that the metal shavings actually petrified all the tissue, so the tissue had to be removed.
NEIGHMOND: And his artificial hip had to be screwed directly into his pelvic bone, causing chronic pain. And things Douglas used to do with ease are now difficult.
DOUGLAS: I go to the grocery store or something, I have to lean on a shopping cart, taking a lot of the weight off my hips or I can't make it around the store.
NEIGHMOND: The first hip Douglas had was a metal on metal device. It was taken off the market last year and the manufacturer is paying for patients to see their doctors and if they need it have a new hip put in. Douglas is also suing for damages.
But the FDA remains concerned about all metal on metal hips. In rare cases some metal shavings can even get into the bloodstream.
Dr. William Maisel is chief scientist at the FDA Center for Devices and Radiological Health, which regulates hip implants. He says there's a number of questions the agency wants manufacturers to answer.
WILLIAM MAISEL: How long do the hips last? What types of problems are patients having with the hips? And we've also asked them to collect blood samples from patients with hip implants so that we can better understand how much metal is being released into the bloodstream and what affect that metal has on patient health.
NEIGHMOND: Maisel expects the follow-up studies will provide answers.
JOSHUA JACOBS: Can you lift the leg straight up?
Unidentified Man: Sure.
JACOBS: Does that hurt?
NEIGHMOND: At Rush University Medical Center in Chicago, orthopedic surgeon Joshua Jacobs examines a patient who just received an artificial hip that more and more doctors are using - a metal ball and socket with a plastic lining to minimize the shedding of metal particles. Dr. Jacob says it's important to remember artificial hips are the single biggest advance of the century in treating debilitating arthritis.
JACOBS: Because prior to hip replacement, there were very limited options available for patients with end-stage osteoarthritis, so they were really condemned to a life of pain, immobility, lack of function. And particularly if this was a younger patient, they couldn't work and they couldn't participate in society.
NEIGHMOND: And even amidst concerns about certain models of artificial hips, Dr. Jacobs says most patients have no problems.
JACOBS: The majority of patients that have these implants do not need them removed and just need to make sure that they have periodic follow-up with their physician and they're mindful of any changes in the symptoms around their implant.
NEIGHMOND: Like pain, numbness or swelling. Jacobs says researchers are now working to develop more sturdy implants that won't be vulnerable to wear and tear and will last a lot longer.
Patti Neighmond, NPR News.
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