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Hip, Knee Implant Study Raises Questions About Newer Models

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A new hip and knee implant study is raising questions about newer model devices that might not perform any better than older generation designs that cost less. As a matter-of-fact, the older, cheaper models might actually last longer. A big consideration given that when a hip or knee implant fails or needs replacing, surgery is required.

The New York Times said that the newly published study reviewed information from Australia’s orthopedic registry and looked at implants that were introduced to the market 2003 – 2007. Metal-on-metal implants are constructed with both a metal ball and metal cup, said The Times, and were intended to be longer lasting than their predecessors. Unfortunately, the newer generation implants are expected to fail earlier, with replacements needed much sooner than the older implants, which generally last for about 15 years, The Times pointed out.

The Australian study revealed that no new hip or knee device brought to market in the years studied did any better than traditional devices with established track records; 30% actually performed worse. “Not only has the introduction of this technology been potentially detrimental to patient care, but the current approach may be an important driver of increased health care costs,” the authors concluded, wrote The Times.

“There needs to be a careful re-evaluation of current deficiencies in regulation,” Dr. Stephen E. Graves, director of the Australian registry and study co-author, said in an email to The Times. Dr. Graves said he believes that surgeons, hospitals, and health regulators should luck at the study’s results, noting that replacement of less effective, all-metal devices will run in the billions of dollars.

The Australian review was part of a special issue of The Journal of Bone and Joint Surgery, said The Times, adding that although the U.S. does not have a registry, the U.S. Food & Drug Administration (FDA) is funding work to determine if data from other sources, such as databases maintained overseas and hospital-run registries can offer improved device monitoring.

Earlier this month, a separate study appeared in the British Medical Journal and revealed that patients receiving all-metal hip implants were likelier to need repeat surgery versus patients fitted with older devices. The FDA study—which looked specifically at hip replacement—was led by Professor Art Sedrakyan of Weill Cornell Medical College and involved a review of 18 studies, more than 3,000 patients, and the outcomes from over 830,000 hip replacement surgeries reported to various national registries.

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