A Registry Is Needed for Artificial Joints

The July 29, 2008, New York Times reported on page 1 that there is a need for a national registry for artificial joints.  

We agree.


The USA lacks a national database tracking patients who receive artificial hip and knee joints.  A national registry would pinpoint a problem with a medical implant at an early stage.  Essentially, a national database would allow surgeons to share information and experience to see which orthopedic devices pose problems.  Use of defective implants would be halted at an early stage. 

The Times story discusses a patient who had a hip replacement from a well respected orthopedist.  Instead of getting pain relief, the patient was in terrible pain.  The pain came from a defective hip joint.  The patient needed a second hip replacement to replace the defective hip replacement.  The orthopedist determined that the socket was separating from the bone rathe than fusing with it.  This caused agonizing pain as the metal cup moved around in the hip socket and rubbed against bone. 

The doctor told his concerns to the device’s manufacturer, but nothing happened.  Initially, the company told the doctor that he was implanting the device the wrong way.  The orthopedist, who was a paid consultant for the manufacturer, saw nothing change at the company.  He sounded the alarm to his colleagues in his professional association.  Finally, the manufacturer, Zimmer Holdings, suspended sales of this device, a Durom cup.

If there were a joint registry, the manufacturer of the defective joint might have suspended sales months earlier.  Nearly 1,000,000 hip replacement surgeries are done in the USA annually which is about half of the total of all hip replacements worldwide.

Other industrial countries have a registry, such as Australia, Great Britain, Norway, and Sweden.

Because of its registry, Swedish doctors halted implantation of the defective Sulzer Orhtopedics hip.  Its doctors saw that this joint was defective in that patients were having so much pain that they needed a new replacement almost immediately.  Because of the registry, only 30 patients got the Sulzer joint in Sweden.  The Swedish medical community acted on its own.  In comparison, in the USA there was no registry.  The Sulzer device, which was contaminated by oil, continued to be implanted.  About 3,000 patients received the defective hip in the USA.  A slew of lawsuits ensued, and the Sulzer company had to file for bankruptcy. 

Why have not we had a registry in the USA? 

Mark E. Seitelman, 7/30/08, www.seitelman.com


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