In the wake of the highly publicized hip replacement recall made by Johnson & Johnson medical devices unit DePuy Orthopaedics, there is a growing number of complaints and lawsuits filed everywhere. This is not surprising, as tens of thousands of people have been recipients of the said defective hip implants, and a significant percentage of them are presumed affected.

If you or someone you know has also received DePuy’s hip replacement device (specifically their ASR hip replacement system), you should know you have the right to make a compensation claim if you believe (and can prove) that the implant you’ve received is indeed defective or headed toward premature failure.

It is important to note that not all of DePuy’s ASR hip implants a defective. While the currently identified failure rate is around 13%, which is unacceptable and far exceeds the normal rate of 5%, this simply means that approximately nine out of every ten of those who have received the implants are not affected at all. So even if you have indeed received a DePuy hip implant (especially if your hip replacement surgery took place before July 2010), you may not even be affected.

But if somehow you have been experiencing unpleasant symptoms such as pain in the hip area and other complications, and you are not very sure if you have the specific recalled DePuy hip implant model in you, you should contact your surgeon for verification and get some legal representation.

Taking timely action
Acting swiftly in filing a lawsuit is important in order to avoid losing your “window of opportunity. In certain countries or states, something that is called the “statute of limitations” is being enforced. What this means is that there is an “expiration date” for the filing of a lawsuit related to a sustained physical damage or injury. In the case of DePuy’s hip replacement recall, the factors that matter would include when and where you had your hip replacement surgery, what kind of complications you have suffered or endured, and for how long you have been enduring the said complications. Courts will usually only accept the filing of such a lawsuit within a set time. Once you exceed it, not even a top-gun lawyer could help you.

Another good reason why you should not wait too long before taking action is, of course, the urgency or intensity of the pain you may have been enduring—you may need to have to undergo what is called a “revision surgery” to either adjust or remove the artificial hip implant, and such a surgery is usually much more expensive than the original one, not to mention more painful and complicated.

Normally, you can fill out a compensation evaluation form to determine if your situation qualifies you to make the claims you want. For instance, it will have to be determined if the symptoms you are experiencing are directly caused by the hip implant device, and what exactly is the range and extent of such symptoms.

As this is a well-publicized tort, you will find that many legal firms are more than willing to assist you in filing a lawsuit. In fact, most of the leading firms in the US have set up websites to reach out to as many possible defective hip implant plaintiffs as possible. Even a casual “DePuy hip replacement lawsuit” search online can easily fetch you dozens of good leads in this area, and almost everyone is screaming “we are the best and most experienced.”

Depending on your discussion with your legal representative, and also based on your medical evaluation, you may proceed in going with either a multidistrict litigation (or MDL) or join thousands of other plaintiffs like you in a class action suit. Each of the two legal means can offer you their distinct advantages or disadvantages. You will have to thoroughly discuss your options with an experienced lawyer, especially one who have long been engaged in cases similar to this. But for starters, MDL can be lengthy, but it may enable you to get better compensation, especially if you are with a very good and well-experienced lawyer. On the other hand, a class action suit is easier to do—you only have to join thousands of other plaintiffs. Recent developments in the on-going legal investigation into the whole hip replacement recall seem to favor the thousands of plaintiffs. At the end of the day, however, what really matters is making sure you actually get what is due, and to finally get rid of that pain and move on with your life.

As hip replacement is a major and complicated surgery that requires adequate skill and expertise from the surgeon, performing it is always associated with significant risk. While the medical establishment continues to find ways to minimize such risks (such as by perfecting minimally invasive surgical procedures) or to prevent the development of any ensuing complication, a certain percentage of people receiving artificial hip implants will develop unwanted outcomes. One of the unintended consequences of hip replacement is pain—either as a constant, low-level annoyance or as sudden stabs of discomfort whenever one assumes a certain posture or moves in a particular way.

Artificial hip replacements are far from being perfect. And when they do go bad, and you end up having to endure some amount of pain, the following are just some of the (hopefully) helpful answers to your “What could be causing all this pain?” questions.

Discrepancy in post-operation length of your legs: there is always the possibility that after the hip replacement surgery, you may end up with the operated leg being longer than the other one. In fact, this unwanted outcome is among the most common complaints among hip implant recipients. This situation often arises from various mistakes: wrong implant choice, too large femoral component, or the implantable ball may not have been snugly fitted in the socket. It is important to note, however, that it is usual for patients soon after the hip replacement operation to “feel” that the leg with the implant seems longer. The patient should wait a few months and if the feeling does not go away, it is probably a true leg length inequality. If one leg truly ends up being longer than the other, this inequality would put excessive stress on the hip joints, thereby causing pain.

Metal, ceramic or plastic debris accumulating in the tissue and bone surrounding the hip implant: the kind of debris that is shed by your implanted device depends on what material they are made of. The original bone and socket hip joints rely on the cartilage to provide cushion and lubrication. When these bones are removed and replaced with an artificial bone-and-joint structure, the artificial replacement of course has no self-generating lubrication. Instead, the material that makes up the ball and socket will wear over time, entering the blood stream or accumulating in the tissue or bone surrounding the implant.

Recently, the type of implant that has gained some notoriety regarding the shedding of too much metal debris is the metal-on-metal hip replacement. Originally designed to surpass the older metal-on-plastic models in terms of durability and minimal debris shedding, these all-metal implants turn out to cause more problems. The debris causes pain in the immediate vicinity, but the more alarming aspect of this is the little known health effects of such metal debris as it circulates in the blood stream.

Inflammation: Closely related to debris-related pain is inflammation. Worse, the mechanism of this type of inflammation can be complicated. As the artificial hip implant wears, producing particulates, sometimes such debris can spring special cells to action, causing them to consume the nearest bone. If sufficient bone is eaten away, this could loosen the implant. An artificial hip replacement that is no longer snugly placed in the right position can start a cascade of pain-causing consequences. If the inflammation is not severe, the doctor usually prescribes some anti-inflammatory medicine. If worse comes to worst, however, the only way to remove the pain is by removing the cause of it: by having the patient to undergo a revision surgery to correct the implant or remove it altogether.

Bone fracture: Sometimes, the natural bone can also fracture due to its interaction with the implant. For example, when the femoral component of an implant is inserted into the reshaped femur, mistakes could be made that could leave the femur prone to shattering. In other cases, bone loss could also occur in the area surrounding the implant, thereby also leaving the bone prone to the development of hairline fractures that could worsen over time. In some cases, chronic pain is caused by these tiny bone fractures that go unnoticed until the problem literally comes to a breaking point.

The above list of sources of pain after hip replacement surgery is by no means complete. The truth is, many hip replacement patients suffering from one form of chronic pain or another are befuddled over the actual source of their pain. When doctors are unable to pinpoint exactly the source of pain, patients are giving pain killers that could be addictive. In any case, the existence of pain is an indication that something is wrong, and it should be addressed sufficiently and thoroughly.

Sometimes, there are diseases that damage our bones so severely that there is no other choice but replacing the diseased bone with prosthetics. This is particularly true with aging-related medical conditions, such as osteoarthritis. In fact, “osteoarthritis” and “hip replacement” are often found in the same sentence, and in the real world, they are also often mentioned in one breath by doctors who look at a patient’s case and see nothing else but replacing bone with man-made devices.

Aside from the above-mentioned bone and joint disease, there are also other medical conditions that require the radical treatment of hip replacement, such as severe infection, injury, or congenital defects.

Currently, artificial hip replacements come in various types, all with different efficiencies and material character. Each one may not be essentially better than the other, as these specific hip replacement options have their own specific pros and cons. The following are just some general information about the different hip implants that are currently available.

Metal and plastic artificial hip replacement: when the ball and socket of the hip joint are so diseased that there is no other choice but removing them, the metal and plastic hip implant is usually the first choice. Both the ball and socket are made of some inert or medical grade metal, such as titanium, stainless steel, or cobalt chrome. Placed in between them is a plastic lining made of polyethylene, which serves as some amount of cushion and regulates the grinding of the ball against the socket. This hip replacement is either fit snugly into the bone, taking advantage of the bone’s natural structures to keep it in its proper position, or it can be cemented in place.

The metal and plastic hip replacement is among the oldest prosthesis for this part of the body, and they are still widely used because of their good track record. The plastic lining wears down each year by only a fraction of a millimeter, giving it about 15 or more years of life before another surgery may be necessary to “revise” the implant or make some adjustments. And considering that most people who have these implants are 50 years old or older, fifteen years is a good acceptable length of time for most patients and doctors.

Metal and new-generation plastic: a new kind of plastic has been developed, called highly cross-linked polyethylene, to overcome the weaknesses and side-effects of the old plastic model for the ball-and-joint metal prosthesis. This new kind of plastic is supposed to be more resistant to wear and tear than the old one. However, all such assertions are still within “theory territory,” as these types of hip replacements have been available only in the past few years and have not yet proven their durability in actual real world usage. Whether or not this hip replacement will actually last longer than 15 years without a hitch is still something thousands of this implant’s recipients will see.

All-ceramic hip replacement: touted as the kind of hip prosthesis that is most resistant to wear, these ceramic-on-ceramic devices are also highly resistant to scratches and smoother than any of the currently available artificial hip replacements. On paper, the use of ceramic as material for the ball and joint structure offers certain advantages over the older metal-on-plastic models. However, there have been recent complaints from implant recipients regarding some side-effects. Some individuals report “squeaky noises” coming from what is supposedly the implantation area, whereas others believe that these ceramic-in-ceramic hip replacements tend to dislocate. On top of these concerns, this type of device is also fairly new, and therefore has not proven itself in terms of long-term durability and failure-free performance.

Metal on metal implants: perhaps the most controversial of the currently available artificial hip replacements, the metal-on-metal hip implants are currently mired in controversy. Certain manufacturers of these devices are presently defendants in civil suits filed by thousands of recipients of what seem to be defective hip replacements. Like the ceramic-on-ceramic hip implants, the metal-on-metal hip replacements look very good on paper. Made of wear-resistant metals such as chromium and cobalt, the ball and joint structure of this type of artificial hip does not use any plastic lining—the metals are in direct contact with each other. While in theory, metal-on-metal implants wear much less than metal-on-plastic devices, their actual performance in recent years seem to indicate a negative performance. Over the past five years alone, thousands of recipients of this type of implant have lodged a multitude of complaints, ranging from premature failure (the implants failing within five years, as compared with the 15-year usage life of older metal-on-plastic models), constant pain, fracturing, tissue and bone damage, and metal toxicity. According to a recent important study, the failure rate so far of metal-on-metal hip replacements is up to 13%, which is unacceptably high.

Whatever the type of hip replacement you eventually choose, discuss it carefully with your doctor and do your homework.

The hip replacement recall by Johnson & Johnson subsidiary DePuy Orthopaedics has everyone making armchair estimates of all the money involved. The company will have to burn a lot of dough in legal fees and settlement claims with implant recipients, and general approximation places the amount somewhere between $1 billion and $5 billion—maybe even more. But how much does this current hip replacement recall—and also defective products in general—cost their manufacturers in terms of bottom line and market value?

According to its latest financial performance: not so much.

Such are the kinds of questions economic and marketing pundits are currently toying with. For one thing, Johnson and Johnson is a huge, highly respected organization with immense global resources. Its extensive market reach served it well in the past. Despite its research muscle, however, its “high end” artificial hip implants still ended up with defects that left recipients literally screaming in physical and emotional pain. So how could somebody so huge like J & J botch this up so badly?

Of course, another important aspect of this issue that the public is closely watching is how the company will conduct its “damage control.” How will it answer to each and every lawsuit, both in the US and abroad? But while the total cost of the hip replacement recalls maybe in the clear billions, the very fact that a company like Johnson and Johnson made a product that caused pain and suffering among thousands of people is something that will linger in the public’s mind. The matter of defective hip replacements has a significant negative impact on the brand image of the manufacturer. We deal with an exceedingly complicated matter that perhaps one cannot fully measure or put an actual, accurate number on the loss of credibility. If you were a patient who suffered so much and went through incredible pain with Johnson & Johnson’s DePuy ASR hip replacement system, you would probably be screaming your lungs out the next time some doctor mentions you the name “Johnson & Johnson.” Multiply that situation to thousands and thousands of traumatized patients, who will be speaking of their “nightmare” with friends, relatives and lovers, and you get the big picture. A huge, established corporation like Johnson & Johnson can still probably save its image by launching a long-term and expensive marketing and advertisement campaign, but the smaller companies may not be so lucky and resilient.

Further, aside from loss of credibility (if you are in the business of medical cures or devices, you know that credibility is everything), the company’s market value will also depreciate. In fact, the damage to its reputation has already caused Johnson & Johnson a sales decline of about 8.5% in its domestic health products.

Despite this depreciation, however, the company seems to be emerging largely unscathed from the issue. In fact, based on the company’s overall financial performance in this quarter, Johnson & Johnson has not been derailed from its original year-long financial projections, despite the hip replacement recall. And with its “innovative” way of dealing with the recall—by outsourcing the legal and medical services needed to analyze every patient’s claim—it may even end up “profiting” from the whole mess.

Perhaps one of the hottest medical and legal issues these days is the one that involves the failure of artificial hip replacements. The crux of the matter is that the failure—often untimely, prematurely and unexpected—of such artificial hip replacements can cause debilitating injuries that may be worse than the original condition they are meant to treat.

At the heart of the issue is the purportedly high failure rate of new all-metal or metal-on-metal artificial hip or knee replacement devices. Compared with older artificial joints, which usually lasted 15 years or more, these new all-metal artificial hip replacements tend to produce more tissue and bone damage and other chronic side-effects that are never mentioned in the get-go.

Worse, as it turns out, the whole issue is not simply a matter of pointing a finger at one particular manufacturer or at a particular homogenous device. The issue is so complex that many experts believe it would take years for legal authorities and the government to sort it out, not to mention the exceptionally huge amount of money involved in it.

“New” is not necessarily “Better”
Like manufacturers in other fields, makers of artificial hip and knee replacements are constantly churning out “newer” and “more advanced” models of their products. These new products are supposed to have carefully researched and meticulously tested new features that give them distinct advantages over old models. In the case of artificial hip replacements, many surgeries have been performed (numbering to tens of thousands) in the past few years to replace older hip replacements with what are supposedly “better” all-metal or metal-on-metal hip replacement devices. Such all-metal hip replacements consist of a ball-and-joint package that is made of metal, usually cobalt or chromium.

Recent studies, however, indicate a disturbing fact. According to an important orthopedic study, the newer hip replacement devices are not actually more durable than older models made of composite materials. Worse, the performance of the newer devices lags behind the very ones they are replacing. In fact, roughly a third of such new hip replacement devices fail within five years—this compared with the usual 15-year “life” of older models. The premature failure of all-metal hip replacements means tens of thousands of surgical removal would be necessary in the coming years, at great cost to patients and their families, and indirectly, to tax payers as well.

Even without access to the full details of the problem, one can easily imagine the “horrors” brought about by this medical mess. Needless to say, defective artificial hips—presumably implanted in tens of thousands of patients since 2005—are causing widespread financial trouble. Such a problem does not only affect the patients themselves, but also every one else that is involved—the government, insurance companies, the employers of patients who had received such defective artificial hips. One estimate places the average hospital and medical bills at $300,000 per patient—but take note that such an amount is well within conservative estimates. Multiply that to several thousands of recipients of defective hip replacements, and you find yourself staring at billions of dollars of money hemorrhaged from taxpayers, insurance companies, individuals, and the government. This, indeed, is like rubbing salt on the country’s already bleeding healthcare wound.

Emotional and Physical Costs
Of course, aside from the mentioned financial drain on patients and any related party, defective artificial hips can also cause great emotional and physical suffering. Consider the fact that having to undergo any surgery already entails some amount of physical pain. Now imagine having to undergo a subsequent “corrective” surgery (or, in some cases, multiple surgeries) just to remove the defective hip replacement that had just been implanted. The collateral damage to tissue and bone can be significant, and therefore, incredibly painful. Add to that are the weeks or months a patient may spend trying to recover from the operation, if that is possible at all.

Any trauma or injury that involves the bone is, to put it simply, extremely painful. And at times, the pain can not be dulled by ordinary painkillers—there are cases in which only powerful sedatives are useful. These considerations are taken into account whenever a major surgical operation is involved. With the pain of artificial hip replacements, the suffering could be tremendous.

Take, for instance, the case of a certain patient who had had an artificial hip replacement a few months ago. Soon after the first operation, due largely to what turned out to be a defective artificial hip, the patient’s pelvis fractured. This required a subsequent surgery to remove what had been implanted.

To make matters worse, some serious infection developed at the site of surgery, leaving the patient having to live without a hip for the ensuing months. The patient’s condition required high-level care for five months, so you can imagine how huge the hospital bill eventually amounted to: about half a million dollars, excluding doctors’ bills, which in turn meant an ever deepening emotional suffering. When you can no longer leave the house and do the things you used to do, or when you are conscious, in pain, and unable to leave the hospital bed, it’s not easy to put a price on the emotional damage you have endured.

Often, the kind of side-effects that arise from defective hip replacements are such that the patient loses physical independence or mobility, leaving them completely reliant on the assistance of others. There are cases in which the defective device damages the tissue and bone surrounding the implant, thereby crippling the patient or subjecting them to live a life saturated with uneccessary pain.

Defective Artificial Hip Replacements: the Bottom Line
The rising cost of artificial hip replacement failure is currently one of the hottest medical issues, especially against the backdrop of the already sensitive matter of health care. What’s more, although the financial drain is the most obvious consequence of these defective hip replacements, it is not only about money. The almost incredible suffering endured by recipients of such implants may never be fully measured in ways that may make sense.