What is a Stryker Rejuvenate or ABG II Victim Who Has No Symptoms To Do?

Cal Warriner
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Posted by Cal WarrinerAugust 11, 2012 12:53 PM

Since Stryker’s recall of the Rejuvenate and ABG II hip implants I have spoken with many clients and their doctors who are very concerned about exactly what to do now that they know this hip implant can cause serious bodily injury.

For those patients who have elevated heavy metals in their blood serum, pain and evidence of tissue destruction on MRI scanning, the decision is easy. The defective device needs to come out. Of course some patients can’t afford to have the procedure but that is another issue.

What are patients who have been implanted with the defective device to do if they don’t yet have symptoms? Or, if their symptoms are mild and the blood tests and MRI scans are normal. What are their doctors to do?

There are no easy answers to these questions.

From the patient’s perspective, despite the lack of symptoms they have to live with the fear that the defective device implanted in them has the potential for causing serious harm. Just because the device is not yet causing symptoms certainly does not guarantee that those symptoms will not start tomorrow.

The harm caused by a Rejuvenate failure can basically be divided into two categories. First, when fretting and corrosion causes metals to be cast off from the device, the soft tissue around the device can die. Nasty fluid can build up and pseudo tumors can form. The metals can even destroy the bone and muscle around the device. It is the effects of this process that cause pain. Unfortunately, by the time the pain starts, the process of tissue destruction is already underway.



The second problem and more concerning to many of these patients is the systemic effects of heavy metal ions circulating in the blood. Several of these patients have done their own research. Medical literature exists to suggest that cobalt and chromium can cause neurological disorders, cardiac arrhythmias, organ failure and even cancer. These potential problems cause patients a lot of anxiety.

I have had clients/patients say it’s like having a ticking time bomb inside their body. But, does that mean patients who do not have symptoms should have the device taken out of their body? That is a very difficult decision.

Yesterday, I spoke with an orthopedic surgeon who implanted many of these devices. Unlike a lot of other doctors he has been calling each and every of his patients to inform them about the recall. Some of those patients don’t have symptoms. He has had the difficult conversation regarding what they should do.

The consensus seems to be that even those patients who don’t have symptoms need to be closely monitored. Blood levels need to be checked reasonably often. If the patient does develop symptoms, especially groin pain, you need to see your surgeon immediately.

Keep in mind that the longer the device is implanted before a revision surgery the more complex the revision. Revising a Rejuvenate or ABG II requires the surgeon to remove the femoral stem. Removing the femoral stem comes with a fairly substantial risk of fracturing the femur. One expert I have spoken with likened the removal well fixed femoral stem as being like removing a one-inch piece of rebar from a slab of concrete.

So, many patients have to weigh the risk of leaving the defective device in against the risks associated with removal. For those who are not symptomatic, the decision is easier. For those with symptoms, the decision gets much more difficult.

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