New Research: All Hip Replacement Devices Have Wear Particles

By Chris Centeno, MD /

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hip replacement pain

Hip arthritis is a terrible problem even for advanced regenerative medicine. If patients are caught in the right stage, this issue is very treatable. However, if the arthritis is very advanced, it can be resistant to treatment. So some of these patients will need to get a hip replacement despite trying a stem cell procedure. Up until now, we’ve believed that some devices were better than others. However, a new study suggests that they all have serious problems.

Who is Best Suited for Treatment with Advanced Regen Med?

Unlike clinics peddling magic stem cell treatments, at Regenexx we use our considerable registry data to help guide treatment decisions. In the case of hip arthritis treatment, if you have mild or moderate hip arthritis and are younger than 55, you may be a good candidate for a same-day stem cell treatment with HD-BMC. If you’re older or have more severe arthritis, then only a cultured stem cell treatment would give you a reasonable shot at saving the hip. What if you’re not a candidate for a precise stem cell injection or a stem cell treatment fails? Then you’re a candidate for a hip replacement. Let’s explore those issues further.

What is a Wear Particle?

Mechanical things, no matter how sophisticated, wear down over time. A hip replacement device is no different. When it wears, it produces small shavings of whatever the device is made of, which can cause problems for the patient. What type of complications?

I and others have always assumed that there were some hip replacement devices out there that produce so few wear particles that they would be negligible. However, now a new study reports that all hip replacement devices have wear particle problems.

Hip Replacement Device Types

Hip replacement prosthesis types are named by what makes up the socket and the ball. So a metal on metal means that there is a metal socket on a metal ball. Or a metal on ceramic means that there are a metal socket and a ceramic ball. Many different materials are used which include metal, ceramic, and many types of polyethylene plastic.

New Research on Wear Particles in All Hip Replacement Device Types

The new study looked at more than three thousand hip replacement patients who were undergoing a revision surgery for wear particle adverse reactions related to the implanted device. The authors expected to see more problems related to metal on metal (AKA MoM or minimally invasive Birmingham type) hips, as issues with this kind of prosthesis are well documented. However, that’s not what they found. Instead, ceramic on metal produced more than twice as many adverse reactions compared with other types. Also, these metal debris revisions were performed earlier in non-metal on metal devices as compared to MoM hips. Also, non-MoM hips had more abnormal findings at the time of revision surgery and more adverse events due to surgery when compared to MoM hips.

The upshot? All hip replacement prostheses types produce wear particles that can aggravate and destroy local tissues and can get severe enough to warrant a revision surgery. What can you do if you have hip arthritis and want to avoid this mess? Do the opposite of what most orthopedic surgeons tell patients (wait until you absolutely need a replacement surgery) and get your hip checked early. Also, avoid steroid shots that will make you feel better in the short run and then advance the pace of arthritis by killing off cartilage and bone tissues. You want your hip to be in the best shape possible to benefit from a stem cell procedure!

Category: Hip, Latest News

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6 thoughts on “New Research: All Hip Replacement Devices Have Wear Particles

  1. David Davenport

    Do really mean that the hip SD treatment is futile for a person over 55 with severe hip arthritis?
    That is discouraging.

    1. Regenexx Team Post author

      David,

      Not futile, as many hip patients have been helped over the years with Regenexx-SD, just often not enough. There is a finite number of stem cells possible in a Bone Marrow Aspiration, which in the case of severe hip arthritis only, tends to be less than is needed. In the cultured procedure, that same starting number of stem cells is cultured and allowed to grow to approximately 100 times the original number. Please see: https://regenexx.com/blog/blogging-from-the-caymans-again-5/

  2. Karen Olkowdki

    I have been diagnosed with severe right hip osteoarthritis and an only 58 years old. A full hip replacement has been recommended. I am not ready for that commitment. Am I candidate for stem cell injections.

    1. Regenexx Team Post author

      Karen,
      Candidacy is established through the Candidacy process. You can either submit the Candidate Form and be set up to speak to one of our Doctors by phone right from your own home as they read your MRI and take a medical history, or if you live locally, you can choose to forgo that step and go through that process at the in-person exam. Each case is unique, we might not agree with the diagnosis of severe hip arthritis, and many factors go into Candidacy, however generally speaking Severe Hip arthritis usually needs the additional stem cells only available with the cultured procedure. Please see: http://www.regenexx.com/blog/new-research-knee-and-hip-oa-are-different/

  3. Deborah Black

    For several years, I have been following articles that feature research in the stem cell and 3D bioprinting fields with the hope that one day there might be a truly viable biologic alternative to the current artificial materials used in hip joint repair and replacement. A fairly recent article that I found seems encouraging on this front (see links below). As a lay person reading this, my impression is that the gene implantation and drug manipulation outlined could produce Frankensteinian results, if unintended consequences should manifest later; however, I was intrigued with the basic aspect of creating new cartilage grown from your own stem cells on a 3D scaffold (as pictured in article) and whether it might potentially survive, if one or two of the Regenexx cultured stem cell treatments were to be introduced in relatively quick succession following surgical placement of the cartilage. I really appreciate the time and effort Dr. Centeno has put into educating people through his blog posts and would welcome any comments he may care to share on his review of this article (http://www.medicalnewstoday.com/articles/311761.php) or the actual research referenced (http://www.pnas.org/content/113/31/E4513.abstract).

    Note: I have had advanced OA in my right hip since 2008 and had the Regenexx-C treatment performed by Dr. Schultz in Grand Cayman during the August 2014 clinic. Given my very advanced condition by that point in time, I feel that the results were fairly remarkable. I’ve not experienced much pain with my condition, even though I’ve been bone-on-bone for about 9 years, but I did have even further reduction in pain and improvement in my ROM that lasted well into 2016. I still choose to use a cane for stability due to a leg-length difference and would like to repeat the Regenexx-C procedure after further evaluation later this year.

    1. Regenexx Team Post author

      Deborah,
      Thanks, interesting study. It’s possible that we could see something on the market in the 10-year time frame. This is because the FDA will require full drug style trials. Glad to hear you’ve done so well, and intend to continue the trend!

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
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