JOINT REPLACEMENT SURGERY: STUDIES QUESTION COST, NECESSITY
We live in a society that prizes fitness, and more Americans are pursuing active lifestyles later in life than ever before. That, in turn, has made joint replacement surgery an increasingly attractive — and common — procedure for weekend warriors who are battling arthritic knees and stiff hips.
According to a recent Journal of the American Medical Association article, in 2014 more than half a million hip replacement and 723,000 knee replacement surgeries were performed in the United States, at an estimated cost of $20 billion. Americans are getting artificial joints implanted at a significantly higher rate than other countries, and the patients are trending younger, too. But the authors of that article, from UCLA’s Center for Health Advancement, raise serious questions about how many of those surgeries are truly necessary and the cost involved.
The Risks and Complications of Knee Replacement
There are, of course, risks involved in almost any kind of surgery. Many joint replacement surgeries are unqualified successes, once the patient gets through the rehab period. But as the procedures have increased, with new products hitting the market, so have reports about manufacturing defects and bad designs, costly recalls and painful “revision” surgeries — in some cases, replacing a failed replacement with yet another, “new and improved” model. Such misfires can end up causing misery for thousands and even hundreds of thousands of patients.
The Depuy Knee Replacement Lawsuit
One current controversy concerns the Depuy Synthes Attune Knee System, a knee replacement developed by a company that is part of Johnson & Johnson’s medical devices group. Since Depuy began marketing the device in 2013, the Food and Drug Administration has received numerous reports of “adverse events” involving the product. In 2017 an article in the Journal of Knee Surgery, authored by several orthopedic surgeons, remarked on what they considered to be an unusual number of early failures of the Attune Knee System, a phenomenon that the authors attributed to a “high rate of debonding” between the tibial component and the bone cement used to hold it in place. The publication of that article was soon followed by the filing of the first of what could turn out to be hundreds of lawsuits claiming that the product is defective.
The company has also faced litigation from thousands of patients over certain artificial hip implants. One, a metal-on-metal device known as the ASR XL, began to generate complaints not long after it hit the market in 2005, including reports of the device shedding debris and causing infection, injury, nerve damage, and metallosis, a type of metal poisoning that can lead to bone loss, tissue damage, and other serious complications. Despite mounting adverse reports, DePuy didn’t stop selling the model until 2010. (The company blamed poor sales, not a product defect, for the decision.) Thousands of lawsuits against that product and a subsequent DePuy hip implant, the Pinnacle, are now underway, including 9000 cases filed in multidistrict litigation in the Northern District of Texas. A federal judge there recently entered a $245 million judgment on behalf of six Pinnacle patients who had to have their implants surgically removed; two previous trials resulted in jury verdicts of $502 million and $1.04 billion (later reduced to $150 million).
One in Three of the Surgeries Unnecessary?
Given the high-stakes litigation over some joint replacements, it’s disturbing to learn that some medical experts believe that as many as one-third of the hip and knee replacement surgeries are unnecessary. The authors of the UCLA paper, citing previous studies, contend that patients need to be better informed, not just about the procedures, but about potential risks (such as the possibility of revision surgery) from the devices and other options for pain management; too many, it seems, have unrealistic expectations about the rejuvenating properties of a joint replacement.
Even if the surgery is warranted, the authors found, prices vary widely from one location to another. The charges for the implant itself can vary by thousands of dollars from one hospital to the next, and the entire procedure can cost as little as $17,000 in one area of the country and as much as $60,000 somewhere else. Before consenting to such a major procedure, it’s advisable to consider alternative treatments and weigh all the costs and risks involved.
The Product Liability Lawyers at FDAzar
If you have suffered injuries or undergone revision surgery as a result of failure of a defective medical device, you may be entitled to compensation. The product liability attorneys at Franklin D. Azar & Associates can help answer your questions concerning several devices associated with recalls, adverse events, or possibly inadequate warnings issued to doctors and patients, including Pinnacle Hips, Attune Knee Systems, St. Jude Defibrillators, and faulty shoulder replacements. Contact us for a free, no-obligation consultation.