Articles Posted in Artificial Hip

In the previous post, we looked at the difference between ASR surgery and total hip replacement surgeries.  We also discussed the Depuy’s “metal-on-metal” (MoM) design. Now, let’s look more deeply into the failure of the metal-on-metal design.

The design problem with the Depuy ASR Cup.

The defect in the Depuy ASR artificial hip appears to be related to design. Orthopedic experts have stated that the design of the ASR cup, which is shallower than standard cups made by other companies, is one aspect of the Depuy ASR Hip’s problems. Dr. Thomas Schmalzreid, a surgeon who designed the Depuy ASR Hip has stated that Depuy had known since 2008 that the Depuy ASR cup may have design flaws. Dr. Schmalzried has said that Depuy officials realized in the first few years that the Depuy ASR cup might be more of a challenge to implant properly then competing cups. Dr. Schmalzried has stated that “the window for component position that is consistent for good, long-term clinical function is smaller for the [Depuy ASR Hip]” than other cups.  That is a highly technical (and bone dry) way of explaining that the ASR cup is harder to implant properly into the hip cavity for long-term successful hip surgeries.

In the previous post we looked at artificial hips and what should happen before a new medical device product like the Depuy ASR Hip gets to the marketplace. Now, let’s look a little deeper into the Depuy ASR hip system, its metal-on-metal cup and ball design, and how it failed:

What is “ASR” anyway?

“ASR” stands for “Articular Surface Replacement.” ASR is a surgical procedure that is an alternative to a total hip replacement procedure. In an ASR procedure, only the articular surface of the hip (the cup and the ball) is replaced. On the other hand, a total hip replacement includes not only the cup and the ball, but also a large piece of metal (known as a femoral stem) that is implanted deep into the patient’s femur and on which the ball is attached.

First, a little history is in order to see how a medical device like a Depuy ASR artificial hip gets to the market (and ultimately, into your body).

What is a total hip replacement?

A “total hip replacement” replaces the body’s hip joint with an artificial one, and these artificial hips are usually made out of metal or plastics. A total hip replacement typically consists of four separate parts: (1) a stem, (2) a head, (3) a liner, and (4) a cup (called an “acetabular cup” or shell). After the surgeon hollows out the patient’s femur bone, the stem is implanted. The head is a metal ball that is fixed on top of the stem. The femoral head forms the hip joint when it is placed inside the liner and the cup (the “acetabular shell”).

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