New Academic Paper about Stryker Rejuvenate Revisions

We recently got our hands on Dr. Joseph Nessler’s new academic article soon to be published in The Journal of Arthroplasty. Entitled “Revision of Recalled Modular Neck Rejuvenate and ABG Femoral Implants” the article details general statistics about revision outcomes for patients of the recalled Stryker modular hip implant. Though the article is still unpublished, it was accepted for publication on December 2, 2014 and will likely serve as a good resource for other orthopedic surgeons dealing with the Stryker Rejuvenate and ABG II medical disaster. Dr. Nessler was not alone in this endeavor – Drs. Christopher Walsh and David Markel co-authored the article with him.

The study is a retrospective review of 103 implants where adverse local tissue reaction (ALTR) was found in the patient. ALTR is a reaction to debris that is generated from wear/corrosion debris from head-neck junctions or bearing surfaces or just general corrosion debris in the form of nanoparticles.

Stryker Rejuvenate hip model.

There are several different types of ALTR – the most commonly found form of ALTR is called a pseudotumor, which is a soft-tissue mass with or without effusion. A prominent feature of the ALTR commonly known as a pseudotumor is tissue necrosis. Aseptic lymphocyte-dominated vasculitis-associated lesion (ALVAL) is another form of ALTR, and describes perivascular lymphatic infiltration. Basically, ALVAL entails serious tissue damage. Osteolysis, or bone loss, is another kind of adverse local tissue reaction, though it’s not commonly seen in metal on metal revision cases.

Dr. Nessler’s findings are quite typical of what we see in our clients – but are still shocking to say the least. He found metallic sludge in every single one of his 103 revision cases (100%), pericapsular rind in 82%, and calcar erosion in 85%. Sadly, 44% of his revision cases required extended trochanteric osteotomies. This kind of osteotomy is particularly invasive, requiring the surgeon to split the femur open to extract the cemented femoral stem. In fact, the team found that although their patients had high levels of cobalt and chrome, as well as intraoperative findings of metallic sludge and corrosion products, the implants generally remained stable with no signs of aseptic loosening. Because of this, the team describes the implants as “technically difficult to revise” which explains the high rates of extended trochanteric osteotomies.

Dr. Nessler also explores the causal mechanism behind ALTR in Stryker Rejuvenate and ABG II patients. He describes the micromotion at the neck-stem taper and the way it can generate debris substantial enough to resemble the levels of corrosion and wear at bearing surfaces (like the DePuy ASR hip implant). The average serum cobalt concentration found in his study population was 7.6 µg/L while the average chrome level was at 1.8 µg/L.

If you’ve had your Stryker Rejuvenate or ABG II hip removed or if you’re still being medically monitored by your orthopedic surgeon, please give us a call. We’re still accepting new cases and we’d be honored to represent you against the company which designed and manufactured this defective hip.