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A mile in my shoes: the experiences of ASR hip patients and their families

Lookup NU author(s): Dr Pauline McCormack, Dr Matthias Wienroth, Clare Hopkins, Professor Tom Joyce



INTRODUCTION: The DePuy Articular Surface Replacement (ASR) metal-on-metal hip was withdrawn in both its resurfacing and total hip replacement forms in August 2010 after around 100,000 were implanted worldwide. There has been widespread media coverage in many countries around the world about proven, attendant health problems caused by adverse reaction to metal debris (ARMD). In addition there has been much speculation and some documented cases of wider, more acute health implications. OBJECTIVES: To record and document the views of patients who had been implanted with DePuy ASR metal-on-metal hips to better understand their concerns. METHODS: Thirty-six ASR hip patients and family members took part in three focus groups designed to explore issues around systems, regulation and medical care. Focus group participants were asked, who do you think is responsible for what has happened with metal-on-metal hips? Who should be responsible for ensuring this does not happen again? How has this affected your trust in medicine? With the consent of those present, all discussions were audio recorded and transcribed verbatim. In addition an on-line questionnaire was offered to patients with experience of metal-on-metal hips. To date 112 responses from across the world have been received. RESULTS: Much blame was placed on DePuy as the manufacturer of the ASR hip, and also un-named individuals within the company such as the ‘engineers’ and the ‘executives’. There was vehement criticism of national regulators, such as the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK, and the view was expressed that it ‘lacked teeth’. Patients saw the ASR problems as the result of systemic failure and felt that no one party had been sufficiently bold in heeding early warnings and data. Orthopaedic surgeons had a mixed review, some were commended for their help and assistance while others were criticised for ignoring patients’ concerns. CONCLUSION: We are not aware of a similar study having been undertaken previously. Patients and their families expressed worry, anxiety about uncertain health outcomes and the feeling that existing systems had not adequately protected them from harm. Wherever the ‘blame’ lies, patients view their orthopaedic surgeons as being central to both the problems and the solutions.

Publication metadata

Author(s): McCormack P, Wienroth M, Hopkins C, Joyce T

Publication type: Conference Proceedings (inc. Abstract)

Publication status: Published

Conference Name: 14th EFORT Congress 2013

Year of Conference: 2013

Date deposited: 06/06/2013

Publisher: European Federation of National Associations of Orthopaedics and Traumatology