While watching the July 12th edition of The Steven Colbert Report, I was reminded during his interview with Michael Shermer, of how we Americans are so readily and willingly influenced by marketing campaigns including those involving health care, Orthopedic Surgeons not excluded. Mr. Shermer has written a book, The Believing Brain, From Ghosts and Gods To Politics and Conspiracies-How We Construct Beliefs and Reinforce Them as Truths (Macmillan). In his book, Shermer supports the idea that the natural inclination is to believe and that skepticism and the scientific approach is unnatural. Is his thesis born out in fact?
Today Wednesday, 13 Jul 2011, a headline was published on CNBC.com: “Stryker withdraws from hip resurfacing business”. Above that announcement appears the following ad from a law firm: “The Depuy Hip Recall: Is Your Implant Defective?” Last year, an article appeared in The new York Times (March 3, 2010) “Concerns Over Metal-on-Metal Hip Implants. On February 14, 2011, I wrote my blog calling attention to the growing problem. All artificial hip replacement systems have risks related to implant or material wear but metal-on-metal hip replacement systems have proven to have unique risks in addition to the general risks of all hip implant systems. On the one hand, at the current time, there is no evidence to support the need for checking metal ion levels in the blood if a patient is asymptomatic or has anticipated findings on an X-ray. My experience is such that if you have a metal-on metal hip either of the resurfacing or total hip variety, a yearly follow-up with an orthopedic surgeon is good practice. If you are having any new symptoms, then metal ion level testing is indicated, as is an x-ray so as to exclude granuloma formation or osteolysis, the latter two resulting from metal debris.
So newly converted surgical skeptic, how might you best approach care of your arthritic hip? Seek a surgeon who will discuss a procedure with no greater neurovascular injury rate than 0.4%; a dislocation rate of no greater than 0.2%; an infection rate of no greater than 0.4% and an operating room average of 45 minutes. Inquire about a prosthetic survivorship of 20 years and not a 23-hour hospital stay. Discuss a 97% chance for a satisfactory outcome and not a 3 inch skim incision. Recently, the FDA approved a new Ceramic-on-Metal Total Hip Replacement. Is this the latest and greatest? Better yet, keep reading my blog and hope that I soon can announce the availability of stem cell management for hip arthritis.
In continuing to assure my reader fairness and balance in the field of reconstructive surgery, I want to call your attention to the publication of a Letter To the Editors, I co-authored, appearing in the June edition of the scientific journal Knee Surg Sports Traumatol Arthrosc: “Comparison of two minimally invasive implantation instruments-sets for total knee arthroplasty”