Time Is Not Kind to Some Zimmer Durom Cup Patients

Charleston, SCOver the years we have grown accustomed to older Americans requiring hip replacements, due to arthritis and simple wear and tear. Younger patients with pain in their hips would have been told to try and hold on until they were older. Not so, now. Patients as young as 13 are undergoing hip replacement surgery, and would need every bit of the 18- to 20-year life expectancy of their prosthetic hip. Unfortunately, for many Zimmer hip patients, that expectation has proven unrealistic.

Zimmer hip replacement has been making the news ever since Dr. Lawrence Dorr, renowned orthopedic surgeon and director of the Dorr Institute for Arthritis Research and Education, alerted doctors and the medical community in 2008 with regard to a high failure rate of the Durom Acetabular Component, otherwise known as the Zimmer Durom Cup.

In his communiqué to doctors, Dorr referenced 10 revisions out of 165 hip surgeries involving the Durom Cup, with four additional surgeries then in the pipeline to replace failed Zimmer defective hip replacements.

"This failure rate has occurred within the first two years," Dorr writes. "In the first year the x-rays looked perfect. We have revised four that did not have any radiolucent lines or migration (and John Moreland revised one). These early cups fooled us, but the symptoms were so classic for a loose implant that we operated on the patients. When we hit on the edge of the cup it would just pop free. As time goes by the cups begin developing radiolucent lines.

"We now have one cup at two years that has actually migrated a short distance. It has tilted into varus. We do not believe the fixation surface is good on these cups. Also there is a circular cutting surface on the periphery of the cup that we believe prevents the cup from fully seating. We stopped using the cup after the first revisions."

Beyond any additional pain, cost and frustration that comes with requiring revision surgery so soon is the exacerbation stemming from youth. Jessica Nelson was 13 when she required a double hip replacement. Dr. H. Del Shutte Jr. of the Musculoskeletal Institute at the Medical University of South Carolina, remarked in a YouTube video featuring Jessica's story that "in the past we used to tell people to kind of live with (a hip problem) 'till they got to be in their 60's or 70's, and then at that point they could get it fixed…"

Today, new treatment options together with a realization that joint issues can adversely affect a young person's lifestyle and livelihood for decades has fostered a willingness to address the issue in younger patients. Bernadette Pletcher is another hip replacement patient participating in an endorsement on YouTube. At 42, the mother of three underwent a total hip replacement. Assuming her hip replacements last a full 20 years, Pletcher may need further surgery at the age of 62.

For Jessica Nelson, further surgery would come, ideally, at the age of 33—not 15, were a Zimmer Durom Cup hip replacement fail her within two years.