J&J Hip Attracts Anxiety

Beth Soltero, a medical researcher who underwent a failed metal-on-metal hip replacement, could wind up as a case study herself.

Soltero chose a premium metal hip, marketed by Johnson & Johnson's (JNJ Quote) DePuy, because it was supposed to last longer than older plastic joints. The metal devices carry higher prices, too, boosting profits for the companies that sell them.

But Soltero sensed problems with her own metal hip from the start.

First, she developed a cyst in her abdomen four years after her surgery. She had that drained, only to see a bulge surface in her thigh. She had that mass removed, too, after it grew so large she could see it through her pants leg.

"It went all the way to the joint," she says. "That's when my doctor said, "I think it's your hip."

So Soltero started bracing for removal of the device and a painful revision surgery. In the meantime, she used her skills as a researcher to begin combing through the medical literature for reports of similar problems.

She found little beyond a recent Korean study on metal-sensitive patients whose metal DePuy-made hips had failed. The authors called for further investigation of the matter. In the meantime, Soltero heard that she is now among three patients treated by the same orthopedics practice who wound up with masses after receiving metal hips made by DePuy. She worries about failures and other possible problems.

"I don't know if the other cases ever got reported to the manufacturer," she says. "I don't think I'm going to be one in a million. ... I think the number is going to be higher than they know -- especially if nobody's reporting any of these cases."

DePuy failed to answer questions about its metal-on-metal hips for this story.

Like drug manufacturers before them, orthopedic device makers have been scrambling for new ways to grow -- and attracting some criticism in the process. Big implant companies have been accused of developing devices that seem like gimmicks at best -- and health threats at worst -- as they seek to reignite their once-highflying stocks.

Today, TheStreet.com presents a three-part series that takes a closer look at some of the industry's latest offerings.

Seal of Approval

DePuy is one of several companies planning to expand its metal-on-metal offerings by introducing new hip-resurfacing systems to the U.S. market.

The orthopedic device makers hope to boost hip sales by as much as 15% by peddling hip-resurfacing systems to young patients who would otherwise postpone surgery. The systems supposedly preserve more bone than standard hip replacements while leaving the door open for full replacements in the future.

But some experts have raised questions about hip-resurfacing results.

"The Australian Hip Registry (October 2004) reported that resurfacing arthroplasty has a revision rate twice as high as conventional hip replacement in the first year after surgery," James Waddell, a Toronto-based physician, writes in an article published by the Canadian Orthopedic Association. "Discordant reports, some documenting excellent mid-term results and others documenting high revision rates both early and mid-term, are hard to reconcile."