Be cautious with medical innovations

I saw Billie Jean King on television last night touting a new knee-replacement product. The tennis great had both of her knees replaced last year. She’s back playing tennis and “I feel like I’m 20 again.”

In February, she signed on to promote Smith & Nephew’s Legion knee with the company’s Verilast  technology,  products used in her surgery. The company claims recipients can expect 30 years of use from its innovations under normal circumstances.

“I am living proof of the success of this knee replacement technology. I am no longer in pain, and I can trust that my knees will provide the level of endurance that I demand from my body,” King said, according to

I’m a longtime Billie Jean King fan. She was both a pioneer for women’s rights in tennis and a class act. I’m glad she’s found relief from the knee problems that severely limited her mobility.

But here’s a word of caution: Be wary of embracing new medical products. As a June 26 headline in the New York Times business section said: “In Medicine, New Isn’t Always Improved.” It is an American impulse to covet the new and improved, the article accompanying the headline said, and in medicine, new drugs, devices and procedures have advanced patient care.

“But the promise of innovation can also prove a trap,” the article continued,  “a situation now playing out with dire consequences for possibly tens of thousands of people who received artificial hips intended to let them remain active.”

In the past decade, the medical world started touting metal-on-metal hip implants as a major improvement over the standard metal ball at the end of the femur and a plastic cup that serves as the hip socket. The innovation lured many even though there wasn’t convincing evidence the product was even as good as existing options.

The danger with all-metal hips is that they can shed metallic debris through wear, and this debris can enter the blood and organs, raising the danger of  long-term health risks like cancer. In May, the article said, the Food and Drug Administration ordered manufacturers of all metal hips to undertake emergency studies of patients.

Part of the push for all-metal hips came from the profit motive, the article said. Manufacturers need to keep churning out new products and many doctors want to create specialty markets to get an edge on competitors.

According to one estimate, the Times’ article said, about 500,000 patients in the United States may have gotten an all-metal hip in the past decade, raising the likelihood that tens of thousands will have painful early-replacement procedures.

I was fortunate to dodge the metal bullet when I had my left hip replaced in November 2005. My surgeon opted for the plastic-metal combo. I had left the decision on materials to his expertise. My due diligence consisted of checking out his credentials and the number of hip surgeries he had performed. Beyond that, I saw no reason to second-guess him. I hadn’t heard any scare stories.

So, with all due respect to Billie Jean King, I think anyone contemplating major surgery needs to do a lot of homework, ask a lot of questions and resist the impulse to seek a miracle cure. Baby boomers might recall that we came of age challenging authority. That’s still a good way to go.

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