U.S. Joint Replacement Registry Releases First Annual Report

The first annual report has been released by the American Joint Replacement Registry (AJRR), which was launched in recent years to track problems with hip and knee implants throughout the United States, indicating that about 6.6% of joint replacement operations were revision surgeries to remove or replace devices, with most of those occurring within three months of the original hip or knee replacement surgery.

The U.S. joint replacement registry was created in late 2010, in the wake of problems with metal-on-metal hip replacements and several recalled knee implants, which were not discovered until after large numbers of Americans received the defective artificial joints.

The program is designed to track basic details about implants and the registry is informed when patients need revision surgery, which is designed to provide information on how long certain implants typically last and raise red flags when a particular joint replacement system seems to be failing too quickly or too often.

Earlier this month, the AJRR issued its first annual report (PDF), which includes data submitted by about 120 hospitals involving about 44,000 joint surgeries conducted in 2013, as well as a total of 80,227 procedures conducted since 2008.

The data encompasses only about 4.5% of joint surgeries performed in the United States last year, but that number is expected to expand as more hospitals begin participating in the program.

Discovering Knee and Hip Implant Design Problems

The registry was launched only a few months after a following the DePuy ASR hip recall was issued in August 2010, after data from similar registries in the U.K. detected that the metal-on-metal implant was experiencing failure rates of up to 13% within a few years after the original surgery.

Following the ASR recall, similar problems were linked to a number of other metal-on-metal hip implants introduced in recent years by various manufacturers, which all experienced similar risks of complications associated with the release of metallic debris into the body as the metal parts rub against each other. However, the issues were not discovered until after hundreds of thousands of individuals had the defective implants placed in their body.

Health experts in the U.S. questioned why there was no system in the U.S. to detect similar problems, which may have caused surgeons to stop using metal-on-metal implants long before the first recall.

“We are pleased to be publishing our first comprehensive report characterizing 80,227 procedures,” said AJRR Board of Directors Chairman Dr. William J. Maloney, in a press release (PDF) issued November 6. “The data in this report covers the collection and analysis of data related to hip and knee replacement procedures that have taken place from when we began collecting data up until December 2013.”

The AJRR expects to make such reports annually.

According to the collected data, about 6.6% of all hip and knee replacement procedures conducted in 2013 were revision surgeries. About 3.4% of hip implant procedures were revisions, and 3.1% of knee procedures.

The most frequent reason given for hip and knee implant revisions were infections and inflammatory reactions due to the implant. Most of those revisions occurred less than three months after the device was originally implanted.

In future years, data from the registry may prove useful in identifying risk implants and provide support for hip replacement lawsuits that allege systems have a faulty design.

Thousands of metal-on-metal hip replacement lawsuits have been filed in recent years throughout the U.S., alleging that the manufacturers failed to adequately research the design or warn about the large number of implants that were failing within a few years and requiring revision surgery.

Johnson & Johnson recently agreed to pay more than $2.4 billion to settle DePuy ASR hip lawsuits faced by their subsidiary, resolving about 8,000 cases brought by individuals who required revision surgery prior to August 2013. However, as devices continue to fail, it is expected that thousands of additional hip settlements will be paid by the manufacturer, as an estimated 90,000 implants were sold worldwide before the recall.

Similar lawsuits are pending against manufacturers of other metal-on-metal hip lawsuits, including the DePuy PinnacleBiomet Magnum, and the Wright Medical Conserve Cup .

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