FREQUENTLY ASKED QUESTIONS

GENERAL

How do I know if I have been fitted with an ASR?

If you were fitted with a metal on metal hip replacement after 2003, there is a possibility that it was an ASR.

You should have already received notification from your hospital and a product recall letter from DePuy advising you to go for further tests. If not, we suggest you contact your surgeon or their secretary who should be able to tell you over the phone which hip product you have been fitted with. They might ask you to put something in writing to confirm your personal details, but you are entitled to know which products were used.

What should I do if I have been fitted with an ASR?

Do not delay. Speak to your GP who should refer you back to your surgeon for tests.

What should I do if I have another type of metal-on-metal hip?

There are concerns about other types of metal-on-metal hips and studies and investigations are still on-going. We suggest you contact your GP if you are worried.

Will I need revision surgery?

Not all ASRs fail, but even if you are happy with yours and are not experiencing any pain, you should still go for tests.

I have two ASRs – will they both need replacing?

Not necessarily, but your metal ion levels should be monitored and the situation kept under regular review. Your surgeon will be the best person to advise you about this.

Have I done anything to cause this failure?

No. ASR hips have a tendency to fail early because of certain features of their design..

METAL LEVELS

How to convert your measurements.

We have already looked at acceptable levels, but you do need to know what yours are. These are sometimes given in nanomoles per litre (nmol/L), as is usual in York. To convert these units to the more commonly used micrograms per litre (mg/l) you need to divide the nmol/L figure by 17 for cobalt and 19 for chromium. So, as an example, for a level of 100 nmol/L:

100 / 17= 5.88 mg/l for cobalt, and 100 / 19 = 5.26 mg/l for chromium.

You may hear of levels being stated as "parts per billion" or ppb. The numbers for this unit will be the same as ug/l.

What are the short and long term effects on my health of these raised metal levels?

Unfortunately at the moment there is no answer as no-one really knows, but studies and investigations are on-going within the medical profession. The Support Group have devised a questionnaire which you can request and complete.

How often should I have my metal ion levels tested?

If you had an ASR you should have received a recall letter from the hospital to have a blood test. If the levels are above 120 nmol/L Cobalt or 135 nmol/L Chromium you should be kept under regular review. The British Hip Society recommends a repeat a blood test at least every six months. We suggest that you speak to your surgeon for further advice.

I am having difficulty getting a blood test – can my GP do this?

No. The blood has to be taken in a particular way, to prevent contamination from the metals in the needle. The blood samples then need to go to a specialised testing centre, rather than to your local hospital. For these reasons, the blood sample should be taken in hospital. However, Your GP should be able to arrange this for you.

How quickly will my blood levels return to normal after revision surgery?

You could see a drop in as little as 3 months or it could take 15 months or more. Much depends on the starting level. However, the metal ions do leave the body over time. The particles do not stay in your body forever.

ADVERSE REACTION TO METALLIC DEBRIS (ARMD)

If fluid is found on the hip, does it affect other parts of the body? If fluid is found on the hip, how soon should the joint be replaced? Will I still get fluid build-up after my revision?

In answer to the above three questions ARMD is a relatively new phenomenon about which much is still unknown. A great deal of research is on-going and even the leading surgeons are still learning about the condition. The answers to these questions will depends on many factors such as what your radiology shows, what your blood levels are, what symptoms you have, etc. It is not possible to give general answers to these questions and you should discuss these matters with your surgeon.

PROBLEMS WITH CONSULTANTS

I am not happy with my Consultant - do I have to stay with same surgeon?

You are entitled to request a second opinion and/or change your surgeon. You can do this through your GP by requesting a transfer to a different surgeon. You may wish to seek a second opinion at a different hospital. In many cases, surgeons have suggested to their patient that they seek a second opinion simply because so little is known about ARMD and only a few surgeons have a lot of experience with it.

Can I see any surgeon I like, even if they are outside of my area?

Under the Broadspire scheme [link] you have a free choice of surgeons, whether they are nearby or not. Once your case has been validated by Broadspire, you will be entitled to see them on a private basis. You will not have to wait for an NHS appointment and your NHS Trust will not have to pay for your treatment.

SPECIFIC QUESTIONS ABOUT REVISION SURGERY AND AFTERCARE

From medical information and and/or members' experiences it would be fair to say that revised hips are seldom as good or last as long as the original, recovery from revision surgery appears to be a much slower process with much greater care needed to avoid possible dislocation, and physiotherapy is essential to a good outcome.

Members of the Support Group have experienced varying degrees of success after revision and if you would like to ask other members how they got on, you can get in touch through altogether.hip@gmail.com Please remember that any opinion expressed by Support Group members are their own and do not constitute medical facts or advice.

COMPENSATION/ SOLICITORS

Is compensation worth pursuing and how much will I get?

It is entirely up to you if you want to pursue a claim against DePuy. However, if you choose not to, please be aware that it is highly unlikely that you will receive any compensation out of hand from DePuy in respect of your failed hip and for the injuries/losses that you have sustained as a result.

Regarding the value of the cases, each one is individual and therefore each claim for compensation will be assessed on its own merits so it is not possible to say at this early stage how much your claim will be worth.  The value of a claim will depend entirely on the effect that the failure of the ASR has had on that particular patient.

Pryers Solicitors in York are now acting for over 200 people, from all over the UK, in claims against DePuy.  For more information on how to make a claim you can contact Pryers solicitors here.

Will my treatment be affected if my consultant knows I am seeking compensation?

It shouldn't be, because the Product Liability Claim is against the manufacturer not your surgeon, the hospital or the NHS.  Indeed, many hip surgeons support such claims.  After all, their good surgery has been undone and their patients have suffered through no fault of the surgeon.  The surgeons' workload has increased, with more patients to see and more operations to perform.

I see Pryers are very involved with the Support Group – do members feel pressurised into signing up with them to claim compensation?

No.  Pryers will not contact anyone unless they contact Pryers first.

Pryers do not have details of who is in the Support Group and have no access to their contact information.  Although most members of the Group have instructed Pryers, some members have not.

Pryers have helped set up the Group; have arranged and funded the meetings; and have assisted with the creation of the website.  However, joining the Support Group does not mean you must or would be expected to, claim compensation through Pryers.

SUPPORT GROUP

What does The Group want to achieve?

Our initial aim is to pass on as much information as possible to other ASR patients. There are 93,000 people worldwide who were given one of these hips and approximately 10,000 in the UK. Unfortunately, only a small percentage have come forward to say that they are affected, whereas the research suggests that anything from 30% to almost 50% will fail early, so we want to make as many people as possible aware of the problems but also the options that they have. We hope that in a small way we are achieving this.

Unfortunately, it seems there is still a long way to go. It is becoming increasingly apparent that there are still many GPs who know little or nothing about the product recall or the serious implications to their patients of having had an ASR fitted. Many Orthopaedic departments are also unaware there is a Support Group whose details they can offer to their patients so that they don't feel completely alone and isolated. We are continually trying to address these kinds of problems.

On a much larger scale, the more we have learned, we realise just how woefully inadequate the regulatory system is, particularly in England, and how little protection is afforded by official bodies such as the MHRA(Medicines and Healthcare Products Regulatory Agency) to "the man in the street" from vast corporations seeking profit from our health misfortunes. We have many questions:

  • Why was the ASR approved for use in this country, when it was not in America?
  • Why was it still being fitted here in 2010, when it had been withdrawn from use in Australia in 2009?
  • Why is there so little testing on medical implants compared to that for medicines?

These are big questions and we have provided some links below to other organisations who  are trying to address these issues.

 

Disclaimer

All the information provided by this website and online support group is intended for your general knowledge only and is not a substitute for medical advice or treatment on hip surgery or any other medical conditions. The information should not be considered complete and should not be used in place of a visit, call, consultation or the advice of your doctors.

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07974 545 709
People have joined us from all over the UK and we try to keep in touch with everyone, mainly through the internet, to let members know about topics of interest - such as media coverage and research.

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FAQs

How do I know if I have been fitted with an ASR?

What should I do if I have been fitted with an ASR?

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