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What Kind Of Metal Is Used For Knee Replacement

Depuy Attune Knee Replacement Lawsuits

What kind of hardware is used for a total knee replacement?

Attune knee lawyers filed the first DePuy Attune knee replacement lawsuit in September 2017. Several more Attune patients have filed suits since then.

People filing Attune knee replacement lawsuits claim:

  • The Attune knee failed earlier than expected
  • They experienced tibial loosening with an Attune knee
  • Patients needed revision surgery

Attune lawsuits are still in the early stages. There have been no court verdicts or publicized settlements yet. Attune knee lawyers are taking new cases.

Based on the number of reported failures, there could be hundreds of Attune knee replacement lawsuits. If that happens, attorneys may ask to combine them in a multidistrict litigation . MDLs let several, similar cases move more quickly through the legal process.

What Are The Benefits Of Ceramic

Having used ceramic-coated joint replacement implants for over 25 years, Dr. Pritchett has noted that ceramic-coated implants have superior wear characteristics compared to metal implants. This means that the implants may last longer than traditional joint replacement implants.

All hip, knee, and shoulder implants will create some degree of debris over time with wear. However, the wear on ceramic implants tends to be less than that of metal implants. Additionally, there is currently no scientific research suggesting that patients react negatively to ceramics, whereas there is scientific research documenting patient reactions to metal debris.

In terms of cost and the procedure, there is no difference to the patient if ceramic-coated implants are used instead of traditional implants.

What Is Knee Replacement Surgery

Knee replacement is where portions of the bones that form the knee joint are removed and replaced with artificial implants. It is performed primarily to relieve knee pain and stiffness caused by .

Most people who get this surgery have advanced knee arthritis, in which the knee cartilage is worn away and the surface of the knee becomes pitted, eroded, and uneven. This causes pain, stiffness, instability and a change in body alignment. Knee replacement surgery can also help some people who have a weakened knee joint caused by an injury or other condition.

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Types Of Knee Replacement Approaches

Your doctor will also choose a surgical approach thats best suited to your needs. You and the medical team will engage in pre-operative planning that covers the type of procedure you receive and associated medical requirements.

In order to ensure a smooth procedure, a skilled orthopedic surgeon will map out your knee anatomy in advance so that they may plan their surgical approach and anticipate special instruments or devices. This is an essential part of the process. Possible procedures are discussed below.

Knee Replacement Implant Materials

Knee Replacement Implant Types, Revision Surgery & Recalls

The replacement knee joint is comprised of a flat metal plate and stem implanted in your tibia, a polyethylene bearing surface and a contoured metal implant fit around the end of the femur. The use of components made from metals and polyethylene allow for optimum articulation between the joint surfaces with little wear. Because the knee implant has a flatter bearing, wear is less of a problem than in a hip implant which has a very deep bearing.

Materials which can be used in knee implants are:

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More Multicenter Randomized Controlled Trials Are Needed To Validate Metal Hypersensitivity Testing

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Modifiable patient factors, such as BMI, vitamin D levels and diabetes, can be optimized preoperatively to reduce the risk of infection and other postoperative complications. However, sometimes patient risk factors and how to modify them are not as clear cut.

One area of controversy in preoperative medical optimization is metal hypersensitivity, a delayed immune response thought to occur when a patient receives an orthopedic implant that contains a type of metal to which they are sensitive or allergic. In literature reports, about 10% of the general population were found to have metal hypersensitivity to nickel, cobalt, chromium or molybdenum, Leo A. Whiteside, MD, orthopedic surgeon at St. Lukes Des Peres Hospital in St. Louis, told Orthopedics Today. After total knee replacement, he noted the incidence of metal hypersensitivity increases to 16% to 20%.

Diagnosis of metal hypersensitivity

Diagnosis of metal hypersensitivity can be challenging because there is not much specificity to what has been generally considered symptoms of an allergic response to a metal implant, according to Joshua J. Jacobs, MD, William A. Hark and Susanne G. Swift professor and chairman of the department of orthopedic surgery at Rush University Medical Center in Chicago.

Source: Susan M. Rapp, Orthopedics Today

Skin patch, lymphocyte testing

Testing caveats

Revision surgery

Types Of Knee Implants

Thinking about a total knee replacement? There are a few different kinds of knee implants that are used in this procedure. The different types are categorized by the materials that rub against each other when you flex your knee:

Metal on plastic. This is the most common type of implant. It features a metal femoral component that rides on a polyethylene plastic spacer attached to the tibial component. The metals commonly used include cobalt-chromium, titanium, zirconium, and nickel. Metal-on-plastic is the least expensive type of implant and has the longest track record for safety and implant life span. However, one problem that can happen with plastic implants is an immune;reaction triggered by tiny particles that wear away from the spacer. This can cause bone to break down, leading to loosening and failure of the implant. Advances in manufacturing have greatly reduced the rate of wear in the plastic.

Ceramic on plastic. This type uses a ceramic femoral component instead of metal . It also rides on a plastic spacer. People who are sensitive to the nickel used in metal implants might get the ceramic type. Plastic particles from this type of implant also can lead to an immune reaction.

To learn more about your options for knee replacement surgery, read the Harvard Medical School guide;Total Knee Replacement.

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Ial Knee Replacement Overview

A is also known as unicompartmental knee arthroplasty or unicondylar knee arthroplasty. In this surgery, damaged cartilage and bone are removed and replaced only in one diseased compartment of the knee. This differs from a total knee replacement, in which bone and cartilage from the entire joint are replaced.

Partial knee replacement is suitable for people who experience arthritis only in one compartment of the knee joint, rather than throughout the joint. It can also provide relief from pain and stiffness in some people who have medical conditions that make them poor candidates for total knee replacement surgery.

What Is An Artificial Knee And How Does It Stay In Place

Knee Replacement | metal allergies joint replacement

Artificial knee implants consist of metal and medical-grade plastic called polyethylene.

There are two ways of attaching the components to the bone. One is to use bone cement, which usually takes about 10 minutes to set. The other is a cement-free approach, in which the components have a porous coating that allows the bone to grow onto it.

In some cases, a surgeon may use both techniques during the same operation.

Any operation done with anesthesia has risks, although it is rare that severe complications result from any type of anesthesia.

The options for TKR include:

  • general anesthesia
  • spinal or epidural
  • a regional nerve block anesthesia

An anesthesia team will decide on the most suitable options for you but most knee replacement surgery is done using a combination of the above.

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How Long Will My New Joint Last

In recent years, improvements in medical equipment and surgical techniques have meant that many knee replacements last longer than they did in the past.

A new study looking at over 6,000 people who have had knee replacement shows:

  • More than 4 in 5 people who have total knee replacements can expect them to last for at least 25 years.
  • 7 in 10 people who have a unicompartmental knee replacement can expect it to last for at least 25 years.

Clearly this will vary between different people, and you still need to take care of your new knee.

How Can Metal Allergies Or Sensitivities Affect Joint Replacement

If a patient has a metal sensitivity or allergy, there is concern that using a metal joint replacement implant may cause a negative reaction that could lead to the need for a revision joint replacement or a compromised result.

Joint replacements are designed for low friction movement but they still shed tiny particles of metal with use. Tissue reactions to this implant wear debris can be a reason for joint revision surgery. However, patients with metal allergies or sensitivities may react more strongly to these metal particles.; For these patients, the new joint becomes inflamed and painful, even though issues like infection, implant wear and loosening have been ruled out.

If a patient has a known metal allergy, Dr. Pritchett recommends metal-free implant options. If a patient is concerned about metal allergy or sensitivity, metal allergy tests can be done but most patients are best served by looking at alternative implant options.

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How Long Does It Take To Walk After A Knee Replacement

Most patients progress to a straight cane, walker or crutches within two or three days after surgery. As the days progress, the distance and frequency of walking will increase.

Patients are usually able to drive a car within three to six weeks after surgery and resume all other normal activities by or before six weeks. Complete recuperation and return to full strength and mobility may take up to four months. However, in many cases, patients are significantly more mobile one month after surgery than they were before they had their knee replacement

Care After The Operation

Knee replacement

Please give some thought as to how you will be looked after once you have had the operation, well in advance. Most people like to be independent, but you are going to need support with day-to-day activities for a while. If you have an able-bodied partner, this might fall to them, but otherwise you may need a friend or relative to come to stay with you for a while. Some people may arrange to stay in a care home until they have their mobility and independence back.

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Frequently Asked Questionsabout Hip And Knee Replacement Materials

What is the chance of my body rejecting the implant?

Unlike an organ transplant, the risk of your body rejecting the artificial hip or knee parts is exceedingly rare. The materials used in the typical replacement surgery are well tolerated by the body and have a long track record of successful implantation. While in rare cases the parts may become loose or infected, this is typically related to other factors and not due to your body rejecting the parts.;

How do I know if I have a recalled implant?

Most modern hip and knee replacement parts have a long history of excellent safety and few known mechanical issues. In recent years, there have been a handful of very specific implants involved in a recall process due to metal reactions, higher than expected failure rates and other unanticipated problems. Most companies offer numerous models and designs of their implants .; It is important to keep in mind that just because one model has been recalled, the company is likely to have many others that are performing very well.;The vast majority of patients will not experience an issue with a recalled implant. If you are concerned about your particular type of replacement, we recommend you contact your surgeons office to ensure that your implant has not been involved in a recall.;

I have a history of nickel allergy and/or break out in a rash with certain types of jewelry. How do I know if I am allergic to the implants?
Can I have a hip or knee replacement if I am allergic to metal?

Different Types Of Knee Replacement Implants

Oct 3, 2016 | Patient

*This post was co-authored by Grace McClure and;Dr. Trevor North

This checklist of factors to finding the best implant may seem overwhelming, but luckily, this decision is usually left in the hands of your orthopedic surgeon. After all, surgeons have preferred implant manufacturers and only a couple different styles they work with. Very rarely do surgeons operate with multiple brands and more than a few styles. Your surgeon should be an expert in the exact type of implant you will receive.

With that said, lets get you acquainted with all things knee replacement implants, shall we? This way, you can assist your care team in matching you with an implant that best matches your lifestyle, activity level and other requirements.

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Total Hip Replacement Materials

Standard total hip replacement implants are typically made up of approximately four individual components :

  • Steminserts into the femur or thigh bone
  • Cupinserts into the pelvic bone
  • Ballfits onto the end of the stem
  • Linerinserts into the cupessentially becomes your new cartilage
  • The Stem

    The femoral stem is the portion of the replacement that fits into your thigh bone. Historically, this is made from cobalt-chromium and/or titanium metals. In the modern era of hip replacements, cemented stems are composed of cobalt-chromium metals. Cementless stems are routinely made of titanium. Both designs have had excellent long-term results as part of total hip replacement systems.

    • Both titanium and cobalt-chromium implants are considered highly biocompatiblemeaning they are generally well tolerated by the human body with low risk of adverse reaction. In fact, both materials have been shown to be highly effective in adhering to bone.
    • The top end of the femoral stem is specially shaped to hold the new ball of the artificial joint. Regardless of the material that the ball is made out of, this is where the head and stem fit together.

    The Cup

    The acetabulum structure fits into your pelvis and is also made from various metals. The majority of modern cups are made from titanium or tantalum metals. Both metals are well tolerated by human bone and serve as excellent surfaces for bony attachment.

    The Ball

    The Liner

    Figure 1

    Total knee replacements are made of 4 parts as well :

    The Femur

    Reasons For The Procedure

    Knee Replacement Implants – What Do They Look Like And What Are My Options?

    Knee replacement surgery is a treatment for pain and disability in theknee. The most common condition that results in the need for kneereplacement surgery is osteoarthritis.

    Osteoarthritis is characterized by the breakdown of joint cartilage.Damage to the cartilage and bones limits movement and may cause pain.People with severe degenerative joint disease may be unable to donormal activities that involve bending at the knee, such as walking orclimbing stairs, because they are painful. The knee may swell or”give-way” because the joint is not stable.

    Other forms of arthritis, such as rheumatoid arthritis and arthritis thatresults from a knee injury, may also lead to degeneration of the kneejoint. In addition, fractures, torn cartilage, and/or torn ligaments maylead to irreversible damage to the knee joint.

    If medical treatments are not satisfactory, knee replacement surgery may bean effective treatment. Some medical treatments for degenerative jointdisease may include, but are not limited to, the following:

    • Anti-inflammatory medications

    • Cortisone injections into the knee joint

    • Viscosupplementation injections

    • Weight loss

    There may be other reasons for your doctor to recommend a knee replacementsurgery.

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    What Makes A Knee Implant Best

    Asking orthopedic surgeons what knee replacement is best is like going to a car show and asking people which is the best car. You’ll find lots of different answers, and each person thinks they’ve got the right answer.

    One of the most important aspects of knee replacement surgery is determining the proper implant to be used in the operation.

    However, people disagree on what criteria are most important to select the best knee replacement implant.

    • Do you use the implant with the newest design;or the implant with the longest track record?
    • Does a surgeon use many different implants depending on each patient, or become most comfortable with one implant for every patient?
    • Should a surgeon use implants suggested or asked for by their patients?

    Orthopedic supply companies have begun to advertise directly to consumers. The advertisements might make you believe that their implant has been shown to be better than other implants. This has been seen with ‘gender-specific knee replacements‘ and ‘rotating knee replacements.’

    Understanding The Materials Used In A Knee Replacement

    We live in a wonderful time of impressive technological and medical advancements. We can treat many disorders, but unfortunately, we cannot treat aging. In other words, despite living longer, we fall prey to old age and its numerous ills. One of the most common issues that come with aging is getting a bad knee. Fortunately, there is a fix: knee replacement surgery. To learn about which of the materials used in a knee replacement surgery is best suited for you, check out this article!

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    Find The Best Knee Replacement Implant: Top Brands

    There are more than a dozen manufacturers of artificial knee implants. However, like anything else, some knee implant manufacturers have a larger market share than others. In the US, the most popular knee replacement parts manufacturers are Zimmer , Stryker, DePuy and Smith & Nephew.

    Here are the top brands and styles used by surgeons in the US.

    Zimmer is the most popular manufacturer of knee replacements. In fact, according to Zimmer, more than 25% of knee replacements implanted worldwide are a Zimmer product. Thats a whole lotta implants!

    Different Styles


    Biomet, who has recently merged with Zimmer and is now called Zimmer Biomet, offers a nickel-free implant for those with allergies. They also offer an antioxidant polyethylene material insert component to pair with their tibial and femoral parts. In saything this, there is nothing to prove that antioxidant plastic holds any true benefit. Admittedly, it sounds pretty good though!

    Different Styles

    Among the most popular manufacturers in the US, Stryker offers total, partial, and revision knee replacement systems that are suitable to a wide variety of patients. Stryker implants are used in over 100 countries.

    Different Styles


    Different Styles

    Smith & Nephew offers a wide range of replacement variations that fall under their Legion family. This includes replacements made from oxidized zirconium, a nickel-free metal thats suitable for patients with metal allergies.

    Different Styles


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