Eight years ago, I sat in a surgeon’s office as he showed me X-rays of my deteriorating hips. He told me they were finished. I was only in my 50s, but I wasn’t surprised. By the time I saw him, I could scarcely walk. I had skied and hiked and led a reasonably active life, but now I was a cripple. Sometimes I had to use the railings to drag myself hand over hand up the stairs.
Artificial hip replacements are among the great blessings of modern medicine. They have restored mobility to millions of people. Hip surgery is generally low-risk and highly successful. For aging boomers, that’s the good news. For me, the bad news was that I would have to spend a long time disabled and in pain before having the surgery. The backlog in Ontario was much bigger than now. I would have to wait about a year for my first hip and another year for the second. After that, I’d have to be careful. No tennis, no yoga, no skiing.
The other problem was that the new joints wouldn’t last forever; I would need replacements when they wore out. I hobbled back to my car and cried. Then I did what modern patients do: I consulted Dr. Google.
Soon I found some more good news. A top orthopedic surgeon in Montreal was doing a newer procedure called hip resurfacing, specifically targeted at younger, active people. Resurfacing, which is an alternative to total hip replacement, had been popular in Europe for years. The advantage was that, after surgery, you could do everything again. There was also another innovation on the market – all-metal implants that promised to last much longer than the standard metal-and-plastic devices that had been in use for years. My crumbling arthritic joints would be replaced by a shiny ball and socket made of cobalt and chromium – a miracle of medical engineering.
The waiting list in Montreal was short. Within months, I had two new metal hips made by DePuy Orthopaedics Inc., which started out making splints for Indiana farmers in 1895. I even wrote about them in The Globe and Mail. Readers across the country asked for my advice. Many of them wound up getting the same type of implant.
I also heard from orthopedic surgeons. One or two were surprisingly vitriolic. They didn’t trust the new devices. They warned me that bad things would happen to my hips. That was when I learned that medical opinion, to put it mildly, was sharply divided.
Today, the miracle has turned into a nightmare.
With the aging of baby boomers, joint replacement is big business – about 40,000 Canadians will receive one this year alone. But metal-on-metal hip devices, including the kind I have, have failed in thousands of patients, with several models taken off the market and leading companies facing massive litigation.
Many of the half-million people to receive metal implants worry about the future, warned by lawyers that they may feel fine, but tiny fragments may leach into their bodies and poison them.
I have always been skeptical of medical scare stories. I know that litigation lawyers are paid to make the worst of things, and the pharmaceutical industry is a ripe target. The high cost of medical litigation drives up the cost of medicine for us all, and may even slow the pace of innovation. In many cases, the biggest winners are lawyers, not patients.
Yet, my faith in medicine and Big Pharma – DePuy is a division of Johnson & Johnson, the biggest pharmaceutical company in the world – has been well and truly shaken. Sometimes the latest shiny product is not so great. Things can go wrong, even if you are an educated consumer.
Gloria McSherry was an educated consumer – the active wife of a successful business executive and once a keen runner. Now a resident of Dunedin, Ont., about an hour’s drive north of Toronto, she was in her early 50s when she was diagnosed with arthritis in her hip.
In 2007, she was given a Zimmer Durom Cup. “The surgeon praised it highly,” she says. It was supposed to make her more mobile than other implants, and to last longer.
It was a catastrophe. After receiving the new hip, she says, “I just could not get well. I got these incredible episodes of pain where I felt as if it would exit my body.” A year after her surgery, walking was still difficult and painful. The implant scraped and jammed. Even though her X-rays looked fine, she wasn’t functioning. Her surgeon had no answers and neither did anybody else. The wear and tear on her personal and family life was profound.