Cobalt Chromium Toxicity

stryker accolade hip

Increased Risk of Complications with Stryker Accolade


The Stryker Accolade is associated with an elevated rate of implant migration and loosening. There are clinic factors which contribute to the increased likelihood of complications and subsequent failure of the hips: aseptic loosening of the femoral component was associated with implant instability and micro motion (excessive motion at the implant-bone interface). Hip implant complications significantly affects patient function, results in hip implant failure and a need for revision surgery.

 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3254738/pdf/11999_2011_Article_2160.pdf

Metal-on-Metal Hip Implants and Revision Surgery


Patients undergo hip replacement surgery in order to improve their quality of life. Hip replacement surgery is supposed to increase activity levels, improve range of motion, and ease pain and suffering. Unfortunately, after their index (initial) surgeries, individuals soon find their hip replacement is hindering rather than helping. This is often the case with metal-on-metal hip replacements.

Metal-on-metal hip systems such as the DePuy PinnacleDePuy ASRStryker Rejuvenate, Stryker ABG IIStryker AccoladeWright Pro Femur and Wright Conserve, have the highest failure rate compared to any other hip implant. Most individuals experience serious complications and subsequent failure with these implants. Complications from metal-on-metal hips include cobalt-chromium toxicity, metallosis, pseudotumors, infection, loosening and implant wear, joint stiffness, and fracture. These complications cause implant failure. Implant failure requires a second surgery, known as a revision surgery. A revision surgery requires removing the failed implant(s) and replacing with a new device.

Revision surgery is more complex and risky than the index surgery because it is more invasive. Therefore, the risk of complications is greater with a revision surgery than initial surgery. The implants are more likely to loosen, migrate, and fracture since the bone and hip joint are severely manipulated from the previous implant.

Hip Surgery: The Importance of Doctor-Patient Communication


An open and honest dialogue with your doctor before surgery contributes to better outcomes. This means providing your physician with a comprehensive medical, surgical, and social history. This also ensures the doctor gives you the best care in creating a plan that fits your specific needs. Before any surgery, it is essential to voice any questions or concerns you might have.

The American Academy of Orthopedic Surgeons (AAOS) created a list of questions which may help in discussions with your doctor:

  • What are your experiences with specific hip implant devices and how often do you use one over the other?
  • What are the risks and benefits of different devices (metal-on-metal, metal-on-polyethylene, ceramic-on-polyethylene, and ceramic-on-ceramic devices)?
  • If applicable, what is the surgeon’s personal experience and outcomes with the respective devices?
  • If your surgeon recommends a certain device, ask why that hip implant is the best for your situation.
  • What are the major and/or most frequent complications of surgery?
  • Is the skill and experience of the orthopaedic surgeon more important than the device or procedure?
  • Can you give me any information on outcomes and complication rates?
  • If I do not have surgery, what is the risk?
  • How much pain can I expect, and how will it be managed in the hospital and after I go home?
  • How long will the device last, and what can I do to make it last as long as possible?
  • What are the pros and cons of minimally invasive (mini-incision) surgery? Does it really make a meaningful difference in the result, or does it pose unnecessary risks?
  • What will I be able to do/not do after my total joint replacement?
  • Is therapy necessary after surgery?
  • How long will I be in the hospital?
  • Will I be able to contact you after the surgery if I have a question or problem?

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