Hip Replacement Complications and Claims
Legally Reviewed and Edited by: Terry Cochran
Hip replacement surgery is a relatively common surgical procedure and one of the most successful; patients expect them to last for a good 20 years or more. Advances in replacement hip joint prostheses have not always made progress, and several big lawsuits and settlements for over $7 billion have resulted since 2000.
Complications after hip replacement may be the result of a faulty device or medical malpractice. At Cochran, Kroll & Associates, P.C., we are experienced medical malpractice attorneys and product liability lawyers who can help you get the compensation you deserve for your pain and suffering. If you are seeking guidance for your product liability or medical malpractice case, contact our law firm for a free consultation to find out how we can help you or your loved one.
Hip Replacement Surgery
Hip replacement surgery is performed to replace damaged parts of your hip, such as from arthritis damage, when conservative treatments for pain have not worked, or if your hip joint was damaged in an accident. It is also called Hip Arthroplasty.
The damaged parts are replaced with surgical prosthesis manufactured from metal, hard plastic, or ceramic.
The most common causes of damage to a hip joint include:
- Osteoarthritis (wear-and-tear): The smooth cartilage that allows joint movement is damaged. Progressive degenerative osteoarthritis is more common in joints with prior damage.
- Osteonecrosis: A lack of blood supply to parts of the hip joint leads to necrosis and the eventual collapse of the joint, which can be caused by fractures, drugs (i.e., prednisone), alcoholism, or systemic diseases such as lupus.
- Rheumatoid arthritis: An autoimmune condition that causes inflammation that eventually leads to the erosion of the cartilage and bone.
- Accidents that cause damage such as the fracture of the neck of the femur.
Hip replacements doubled between 2000 and 2010, and there is a concern that the rising tide of obesity is partly to blame for this sharp increase, due to the impact of excess weight on joints. Gym workouts are also resulting in more women sustaining injuries, and the number of patients under the age of 60 requiring hip surgery is on the rise as well. By 2010, more than 2.5 million people in the US had hip replacements
Your doctor may recommend an elective hip replacement when the damage interferes with your daily activities of living such as:
- Rising from or sitting down in a chair
- Going up and downstairs
- Pain worsens when walking
- No comfortable sleep position due to pain in the hip
- Conservative pain relief no longer has any effect
- Pain is chronic and severe
Types of hip replacements can include a partial replacement, where only the ball or socket is replaced, or a total hip replacement, where both are replaced. Most are done the traditional way; however, some orthopedic surgeons use minimally invasive techniques.
Most hip prosthesis consists of a prosthetic socket that is implanted into your pelvic bone to replace the damaged acetabulum (socket), and it is typically made from a hard plastic material. The ball joint on top of the femur is replaced with a prosthetic ball, attached to a stem that is placed into the femur, and this is typically made with polished metal or a ceramic and fits into the prosthetic cup.
During the last decade, metal-on-metal replacement joints were marketed for their longevity but unfortunately had many complications.
Known Possible Complications for Hip Replacement Surgery
While the failure rate of hip replacement surgery is strikingly low at only 1%, you should be aware of possible risks to help mitigate them. Failure is more common in males, obese patients, or those with multiple co-morbidities, and in those with an uncemented prosthesis. Other risks for failure include:
- Infection is always a risk in any surgery – it can occur at the incision or in deeper tissue and can be treated with antibiotics. If it occurs inside the joint, it may have to be replaced. In hip replacement surgery, it only occurs about 1% of the time, and of those, 60% are superficial. Patients are advised to take antibiotics before dental or other elective procedures post-surgery for several months. Comorbidities such as diabetes increase the risk of post-surgical infections.
- Inflammation and swelling are common post-surgery; however, sudden swelling of the leg and inflammation may point to a blood clot and requires immediate attention.
- Complications related to anesthesia – the procedure can be done under general anesthetic or with a spinal block, both of which have typical anesthesia risks.
- Intraoperative fractures – parts of the hip joint may fracture during the procedure and could heal by themselves if small enough, but may require fixation with wires or plates.
- Bone-cement allergies – these are very rare, but they can cause failure. Some replacements are done without cement, which can also increase failure risk.
- Death is an extremely rare complication.
Total Hip Arthroplasty Dislocation
This can occur in the first few months, and patients have to guard against being overactive or overconfident, or against falls or sudden jerking movements in the postoperative period, for up to 12 months:
- An abductor pillow is used to prevent the patient from crossing their legs post-surgery.
- The patient must guard against rotating the leg inwards, as well as avoid hyperflexion.
- They are advised not to lean over when sitting down or in bed because if the hip is bent past 80 degrees, it may dislocate.
- Patients should avoid squatting.
- Pivoting or twisting the leg must be avoided.
Dislocation is more common in the elderly (over 80), alcoholics, those with a weak muscle structure around the hip, or in repeat procedures; thus, physical therapy is imperative.
A dislocation may be treated with a brace; however, if it keeps reoccurring, it may require surgery. About 4% of patients have a dislocation post-surgery, making it the most common complication for the procedure.
Metal-on-Metal Implants (MoM)
This joint prosthesis has a joint made of two metal surfaces, where both the ball and the cup are made of metal.
It promised a longer lifespan for the joint prosthesis and a decreased risk of dislocation or device fracture. However, many of them deteriorated much quicker and released metal ions into the patients’ bloodstreams.
All hip prostheses wear down over time, and while most do not wear down enough to warrant replacement, in some cases this is necessary. Certain metal-on-metal implants wear down much faster than others, and the friction on the surface causes tiny metal particles to break off. When they enter the space around the hip joint, they may cause inflammation and discomfort.
Patients with metal-on-metal implants are advised to check in with their doctor frequently and to consult their doctor immediately if they feel discomfort. The inflammation may cause damage to the surrounding tissue, which can lead to deterioration of the hip joint structure. When the prosthesis becomes loose, it can cause a lot of pain and require corrective surgery and replacement of the joint.
Levels of chromium and cobalt ions in the bloodstream indicate just how much wear-and-tear the hip joint has suffered since the surgery. It does not lead to sepsis, but in a small number of cases patients with high levels of ions have suffered symptoms related to the heart, thyroid, and nervous system, but no causal link has been found.
The FDA issued a final order on February 18, 2016, requiring pre-market approval for MoM hip joints, both cemented and uncemented, noting that there are increasing reports of complications and potential problems, requiring revision surgery. Only two were approved by the FDA, namely the Cormet Hip Resurfacing System (Corin USA Limited) and the Birmingham Hip Resurfacing System (Smith & Nephew, Inc).
Hip Replacement Lawsuits
There are currently over 13,000 hip replacements lawsuits pending in the US. If you have experienced problems or complications after a hip replacement surgery, you may have a claim against your surgeon, hospital, or manufacturer of your device, and in some cases, all three of them.
An experienced personal injury lawyer at our law firm who specializes in medical malpractice, such as Eileen Kroll, can evaluate your case to see if you can join a class action or MDL (multidistrict litigation) or sue your surgeon, to get compensation for expensive medical and other costs.
Medical Malpractice and Medical Negligence
While there are plenty of cases in which a hip replacement can fail because of product liability, you may also experience complications due to medical malpractice. Issues such as diagnostic errors, medical errors in surgery, and medication errors can contribute to unnecessary pain and suffering, and even further surgeries.
Additionally, if you notice that your leg lengths are uneven, this could be due to negligence and improper placement of the prosthesis.
What Are Your Legal Options?
Complications from hip replacement surgery can have devastating impacts on you and your family. Revision surgeries often create additional costs, pain, and suffering and can seriously impact your quality of life.
Consult with an experienced malpractice lawyer at Cochran, Kroll & Associates, P.C., to review your case and to fight in your corner. You may be able to claim for medical bills, lost wages, caregiving services, other costs incurred due to the complications, as well as pain and suffering.
You will have to be able to meet all four of the criteria for medical malpractice claims, namely, that the defendant(s) had:
- A duty of care (this could be your surgeon, the hospital where the surgery took place and the staff, or the manufacturer of your implant device (prosthesis). Most cases have been filed against the manufacturers.
- That this duty was breached through negligence, carelessness, faulty manufacture, failure to warn, etc.
- That the breach of duty was the direct and explicit cause of the damage, you suffered. This is the difficult part, but where there are already many cases filed (such as in class actions or MDL’s) it is easier to prove causation.
- That you suffered actual damages, and it needs to be quantified in monetary terms, such as economic and non-economic costs.
Statute of Limitations
The statute of limitations for medical malpractice lawsuits in Michigan is two years from the date of the injury, or within six months of discovery of the injury. The statute for product liability and personal injury is three years in Michigan.
This extremely small window of time means that you need to consult with a medical malpractice lawyer as soon as you realize there is a problem. We offer a no-obligation case evaluation.
If we decide to take your case, we begin gathering all of the necessary medical records, testimony from witnesses, and we provide this evidence for examination by medical professionals who can determine there is cause for blame. Medical malpractice lawsuits in Michigan are always first evaluated by a board of health care professionals and lawyers to decide if the medical malpractice suits are valid and can proceed.
Medical malpractice and product liability cases are time-consuming, complex, and can be emotionally draining and should be handled by your lawyer. Call Eileen Kroll, a registered nurse, and personal injury trial attorney, at Cochran, Kroll & Associates, P.C., at 866-MICH-LAW to evaluate your hip replacement case. Our law firm only represents individuals, not insurance companies, and we work on a contingency basis, so we never charge a fee unless we resolve your case.
Disclaimer : The information provided is general and not for legal advice. The blogs are not intended to provide legal counsel and no attorney-client relationship is created nor intended.