With an estimated 300,000+ total hip replacements performed in the U.S. each year, the market is expanding. Though the success rate is high, many risks are associated with hip replacement surgery; those affected have to suffer life-threatening side-effects. Many key players are currently engaged in hip replacement implants lawsuits filed across the U.S. courts. Here's our take on the "An Insider Look: Hip Implant Litigation."

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An Insider Look:
Hip Implant Litigation
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An Insider Look:
Hip Implant Litigation
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2. Every type has unique device design featu-
res such as size, shape, and material, and
dimensions.
Hip implants may need to be replaced eve-
ntually.
What is a Hip Implant?
Hip implants are medical devices intended to restore mobility and relieve pain usually associated with
arthritis and other hip diseases or injuries.
Different hip implants are used in hip replacement surgery. When a hip replacement surgery is performed, a
damaged worn-out hip joint is replaced with an artificial implant.
Types of Hip Implants
Total hip replacement
Hip resurfacing
Hemi-arthroplasty
Bi-polar
Dual mobility systems
Every type has unique device design features such as size, shape, and material, and dimensions.
Hip implants may need to be replaced eventually.

3. Factors Influencing Selection of
Hip Implant
2.3%
Doctors and patients should consider the benefits and risks of the
operation before it’s performed.
Device design features Age
The arthritic damage
Activity level
Weight
Surgeon experience
Implantation technique
Other lifestyle factors
Factors Affecting
Hip Implant Success
Rate

4. Components of a Hip Implant
Acetabular liner
Acetabular component (socket)
Femoral head (ball)
Femoral stem

5. Ceramic-on-Metal:
The ball is made of ceramic and the socket has a metal lining.
Ceramic-on-Polyethylene:
The ball is made of ceramic and the socket is made of plastic (polyethylene) or
has a plastic lining.
Materials Used in Hip Implants
Metal-on-Polyethylene:
The ball is made of metal and the socket is made of plastic (polyethylene) or has
a plastic lining.
Ceramic-on-Ceramic:
The ball is made of ceramic and the socket has a ceramic lining.
The metal components can be a combination of metals like titanium, cobalt-chromium
alloys, or cobalt mixed metals.

6. Major Hip Implant Manufacturers
and their faulty implant
Zimmer Biomet: M2a, Mallory-Head, Taperloc, Durom Cup, VerSys, Mayo Hip, Longevity
DePuy Synthes Orthopedics: ASR, ASR XL, AML, Pinnacle, Prodigy, S-ROM, Marathon
Smith & Nephew, Inc.: Metal liner of R3, Duo, IVS Tunneler, Modular SMF, Modular
Redapt Femoral System, TriGen Hip Nail, Synergy, Birmingham
Stryker Orthopaedics: Rejuvenate, ABG II, Omnifit, Sulzer Inter-Op, Exeter, Crossfire, Trident
HemisphericalSH
Wright Medical Group: Conserve Plus, Profemur Z, Perfecta, Dynasty, Metal Transcend
Corin: Cormet 2000

7. Injuries & Complications
Complications during surgery or later in life can cause debilitating side effects.
Most of the lawsuits are filed due to the risk of metallosis faced by users of metal-on-
metal hip implants. This can arise due to two distinct aspects of the device: the material
and the mechanics.

8. Serious Alleged Injuries
Cobalt toxicity
Metallosis (the build-up of metal ions in the body)
Inflammation and swelling
Limited mobility
Bone, joint, muscle or neurological damage
Necrosis-tissue and bone death due to
metallosis toxicity
Popping, crunching or other noises from the hip caused by movement
Fractures of one or more
components
Premature loosening
Severe pain & Infection
Shedding of metal debris
into the bloodstream
Component corrosion
Many people with these problematic artificial hips have opted for revision surgery to
receive a new hip implant.

9. Lawsuit Status
The FDA classifies metal-on-metal hip systems as Class III (higher risk) medical devices.
Metal-on-metal implants have had some of the highest failure rates among all types of
hip implants.
Most large hip replacement litigations involve metal-on-metal designs.
As of April 2019:
Nearly 29,000 lawsuits are filed against hip implant manufacturers throughout the country.
Most of the lawsuits involving metal-on-metal hip implants have been resolved, and more
than 14,000 hip cases are still pending across the country.

10. DePuy Orthopaedics
MDL NO: 2244: IN RE: DePuy Orthopaedics, Inc., Pinnacle Hip Implant Products
Liability Litigation, in the US District Court of Texas, presided by U.S. District
Judge Ed Kinkeade.
DePuy Orthopaedics is a subsidiary of J&J, approved by the FDA in 2000.
By 2012, almost 1,600 lawsuits were filed against DePuy involving Pinnacle implants.
DePuy never recalled the Pinnacle products, but it stopped selling it in 2013.
As of May 2019: J&J agreed to pay $1 billion to resolve claims involving personal injury
linked to the usage of a metal-on-metal version of DePuy Orthopaedics.
This would resolve more than 95% of the 6,000 Pinnacle Hip Implant cases.
continued..

11. MDL NO. 2197: DePuy Orthopaedics, Inc., ASR Hip Implant Products Liability
Litigation, in the U.S. District Court for the Northern District of Ohio, presided
by U.S. District Judge Jeffrey J. Helmick.
In 2010, DePuy recalled its ASR XL Acetabular System and ASR Hip Resurfacing
System because a large number of patients required revision surgery after
receiving the implants.
In 2013, the company settled thousands of ASR hip lawsuits for $4 billion.
As of April 2019: Nearly 1,586 lawsuits remain pending over the ASR hip.
Status of Lawsuits: Settled but the MDL remains active.

12. Stryker
MDL No. 2441 (in re: Stryker Rejuvenate and ABG II Hip Implant Products Liability
Litigation) before Judge Donovan W. Frank, in the U.S. District Court in the District of
Minnesota.
A state-level the multi-county litigation (MCL) before Judge Brian R. Martinotti in
Bergen County, New Jersey (NJ).
Two litigations were set up due to the high number of claims:
In November 2014, Stryker agreed to settle several thousand claims for $1.4 billion,
encompassing the New Jersey MCL and the Minnesota MDL cases, and for all
claimants who had revision surgery before Nov. 3, 2014.
As of April 2019: 1,226 lawsuits remain pending.
Status of Lawsuits: Settled but the MDL remains active
continued..

13. MDL No. 2768 (In re: Stryker LFIT V40 Femoral Head Products Liability Litigation)
was formed in 2017 to be presided by U.S. District Judge Indira Talwani in the
United States District Court for the District of Massachusetts.
November 2, 2018: Stryker Incorporation announced a confidential, private
settlement for cases linked to both recalled and unrecalled components of Stryker
LFIT Cobalt Chromium V40 Femoral Heads.
As of April 2019: Nearly 600 plus lawsuits are pending.
Status of Lawsuits: Currently in settlement phase

14. Biomet
MDL No. 2391 (In Re: Biomet M2A Magnum Hip Implant Products Liability
Litigation) presided by United States District JudgeRobert L. Miller, Jr., United States
District Court for the Northern District of Indiana
The company agreed to settle most cases in 2014 for $56 Million as orthopedic
manufacturer Zimmer bought Biomet in 2014 and became Zimmer Biomet.
However, not everyone agreed with the settlement offer and chose not to take
part in it.
Not everyone who sued agreed to the settlement.
As of April 2019, there were 203 cases still pending in a multidistrict litigation (MDL)
in an Indiana federal court.
Upcoming Events: Thursday, July 18, 2019 at 1:30 pm (EDT) Status Conference
2014: Status of Lawsuits: Settled but the multidistrict litigation remains active

15. Zimmer
MDL-2158 - In Re: Zimmer Durom Hip Cup Products Liability Litigation before
Judge Susan D. Wigenton in the District of New Jersey.
In 2016: A combined $314 million dollar settlement was offered for any U.S. citizen
or legal resident whose Durom cup was implanted in the US and revised prior to
April 29, 2016, and within nine years of implantation.
As of April 2019: Nearly 90 lawsuits were still pending.
Status of Lawsuits: Settled but the multidistrict litigation remains active
continued..

16. MDL No. 2272: In Re: Zimmer Nexgen Knee Implant Products Liability Litigation,
in the U.S. District Court for the Northern District of Illinois, Justice Rebecca Pallm-
eyer, in 2011. June 2018: A final confidential settlement for nearly 300 lawsuits.
MDL No. 2859: In Re: Zimmer M/L Taper Hip Prosthesis and Versys Femoral Head,
before Judge Paul A. Crotty in the United States District Court for the Southern
District of New York. Created in October 2018.
As of April 2019: Nearly 55 lawsuits are filed.

17. MDL No. 2775 (In re: Smith & Nephew Birmingham Hip Resurfacing (BHR) Hip Implant
Products Liability Litigation) was established in Baltimore, Maryland, under Judge
Catherine C. Blake in May 2017, to more efficiently handle the complex cases.
The MDL lawsuits were divided into two tracks: the“BHR Track”and the“THA/R3
Track,’’trial dates for both are set for 2020. The company faces more than 500 hip
implant lawsuits as of June 2019.
Smith & Nephew

18. Corin: Corin Group PLC and Corin USA Limited
The U.S. District Court for the Western District of Oklahoma excluded the relevant
opinions of plaintiff’s sole liability expert, metallurgist Charles Powell and granted
summary judgment in favor of Corin on all claims stating there was no evidence of the
purported defect in the device nor any evidence of medical causation for the plaintiff’s
alleged injuries.
Wright Medical Technology Inc.
MDL No. 2329 (In re: Wright Medical Technology, Inc., Conserve Hip Implant Products
Liability Litigationwas) was created in February 2012, in the Northern District of
Georgia before United States District Judge William S. Duffey.Jr. Wright faced roughly
2,000 lawsuits over its various hip replacements and agreed to two settlements totaling
$330 million. After the final settlement, the MDL was closed in June 2018. The company
no longer makes hip implants.

19. SOURCE: CDC/NCHS,
National Hospital Discharge Survey,
2000–2010.
The annual number of total hip replacements among inpatients aged 45 and overmore
than doubled between 2000 and 2010, from 138,700 in 2000 to 310,800 in 2010 (Figure 1).
Similarly, the percentage increase in the number of total hip replacements among
inpatients aged 45 and over by age ranged from 92% for those 75 and over (from
41,600 in 2000 to 80,000 in 2010) to 205% for those aged 45–54
(from 17,000 to 51,900).
Total Hip Replacements 2010

20. Global Hip and Knee Replacement Market
Set to be Worth $20.4bn by 2028
The hip and knee replacement
markets are worth approximately
25 per cent of the global orthopaedics
market, growing steadily at a
compound annual growth rate (CAGR)
of approximately 2.6 per cent between
2018 and 2028, says GlobalData, a data
and analytics company.

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