The recent recall of two hip replacement products has many patients wondering what's happening with their implants. Many doctors encourage routine check-ups to see how a device is functioning, but patients and surgeons can lose touch.
People may be surprised that there is no big automatic system for keeping track of artificial joints in the U.S. That could soon change with plans to start a national registry.
Both Kate Sauvain and Nancy Kriege have hip replacements that are working for them now. They wonder how long their implants will last.
"I was a long distance runner and I guess I wore my hips out sooner than most people," said Kriege.
"My cartilage has been attacked so much, it is just not there any more," said Sauvain.
Kriege recently learned her implants were recalled because some patients experienced problems. She was surprised to hear about it from a lawyer and not her surgeon or the manufacturer.
"Hopefully my devices will last for another 30 to 40 years, so that's a long time. I'm going to have to keep tabs on it and make sure everything is okay," said Kriege.
Orthopedic implants generally work well for many patients. The devices are approved by the Food and Drug Administration, and the agency puts recall information on its website. Manufacturers also send out letters announcing recalls.
However, tracking down patients well after a surgery can be difficult. In fact, some patients could be walking around with a faulty implant and not even realize it.
Advocates say a national registry could help in many ways. It could locate patients quickly, keep tabs on the reliability of implants and track physicians performing the surgeries.
"I think it will give us a very good ability to educate patients about how long these devices last and what their individual risk is," said Dr. Craig Della Valle, an orthopedic surgeon at Rush University Medical Center.
Countries such as Sweden and Australia have national registries. A few U.S. companies, and even some hospitals, have them. But the newly-formed and privately-funded American Joint Replacement Registry aims to become our national registry.
The registry's goal is to sign up 90-percent of 5,000 hospitals doing joint surgery. Rush University Medical Center in Chicago plans to be one of 15 hospitals in a pilot program of the registry.
"We learn very valuable things by following patients over time," said Dr. Della Valle.
But whether everyone will be on board is questionable. Doctors and manufacturers may decline participation, worried that negative findings could be used against them. There is also the issue of who will have access and patient privacy, but one local doctor believes most physicians will be willing.
"If I am doing something that is either not getting good results because of something I am doing, or because of an implant I am using, I want to know about it," said Dr. Scott Rubenstein with the Illinois Bone and Joint Institute. "The registry might help get that data sooner."
Sauvain has juvenile arthritis and needed a hip replacement when she was 20, but many surgeons were reluctant to do it because of her age. Sauvain feels a registry could help keep track of her success and help others down the line.
"If I didn't have joint replacement surgery, I would be stuck at home in bed in a wheelchair or something, and so it has really benefitted me in being able to live a normal life," said Sauvain.
The American Joint Replacement Registry was founded by the American Academy of Orthopedic Surgeons. It will be funded by surgeons, manufacturers, payers' medical societies and organizations. The government has also been working for years to establish a national registry.
American Joint Replacement Registry
www.ajrr.net
