Smith & Nephew BHR & R3 Lawsuit Update. I am providing this timely update regarding the ongoing problems with the Smith & Nephew Birmingham hip replacement (BHR) and R3 metal on metal hip implants. This article is a continuation of a series of articles on the general and specific problems with the Metal on Metal (MoM) line of hip implants, addressing individual hip manufacturers. First I’ll address the reasons for a hip implant in the first place.
Reasons for a Hip Replacement
Hip replacement surgery may be recommended if the hip joint is worn or damaged, reducing movement and causing pain even while resting, if there is persistent hip pain that is not responding to other conservative treatments, and if the range of movement in the joint is so impaired that day-to-day activities such as walking are very difficult or impossible.
The most common reason for hip replacement surgery is osteoarthritis, this generalized wear and tear of the hip joint usually due to age or previous trauma.
With osteoarthritis affecting the hip joint, there is damage to both the thigh bone (femoral) head and the hip socket (acetabular joint) of the pelvis.
Who is Smith & Nephew?
Smith & Nephew is one of the world’s largest producers of orthopedic medical products. This medical equipment manufacturer is based in London, England, and sells their products worldwide.
Unfortunately, they are also responsible for the fiasco involving their BHR and R3 Hip Replacement MoM systems, and many patients who have received these defective hip implants have needed painful, and costly revision surgery to correct the damage done.
We are fielding a lot of calls from injured patients who are now ten years plus into their Smith and Nephew BHR and R3 implants and are facing severe problems with their implants as outlined below.
Birmingham Hip Resurfacing System
The scientists at Smith and Nephew were in search of a new hip implant design that would make them stand out in the MoM marketplace. Enter the BHR System which was approved by the U.S. Food and Drug Administration (FDA) in 2006.
The BHR System had the following designs, a femoral resurfacing component in the form of a ball-headed cap attached to the top of the femur with cement and an acetabular component in the form of a shallow, cup-shaped socket designed to replace the damaged surface of the hip socket.
Unlike other total hip replacement systems, this BHR system didn’t replace the femoral stem. The BHR system was developed as a response to the limitations of traditional total hip arthroplasty (THA) in younger, more active patients.
The design and popularization of the Birmingham Hip Resurfacing system are due to the British orthopedic surgeon Mr. Derek McMinn. He began working on the design in the early 1990s, with the goal of addressing the specific challenges posed by younger, active patients. His work in Birmingham, England, led to the system’s name.
Before the BHR, there were other hip resurfacing designs in the 1970s and 1980s. However, these earlier metal models faced challenges, especially concerning the materials used and fixation methods. The BHR improved on these earlier designs with its metallurgy and fixation technique.
Smith and Nephew touted the following so-called benefits of the BHR System which were apparently better than their other hip implant competitors.
Apparent Bone Conservation
The traditional total hip replacement involves the removal of a significant portion of the femoral head and neck to fit the femoral component. Hip resurfacing retains more of the patient’s native bone, and this bone conservation approach appeals to younger patients who might require hip surgeries later in life.
Apparent Activity Level improvements
Younger patients and those with higher activity levels are a unique challenge for traditional THA. These patients often wore out their plastic polyethylene bearings quickly due to increased physical activity. The metal-on-metal bearing surface of the BHR was touted to offer better wear mechanics.
Apparent Natural Hip Biomechanics
By preserving more of the native bone structure, the BHR was designed to restore more natural hip biomechanics compared to a traditional THA. This fact was touted to be beneficial in achieving a more natural movement.
Apparent Potential for Fewer Dislocations
Hip resurfacing designs like the BHR typically use larger diameter bearing surfaces, which theoretically reduces the risk of hip dislocations compared to some traditional THA designs.
R3 Acetabular Total Hip Replacement System
Smith & Nephew also had a THA system, the R3 Acetabular Total Hip Replacement System has a femoral head and cup featuring a metal liner between the two. Unlike the Birmingham Hip Resurfacing System, the R3 Total Hip Replacement System uses a femoral stem implanted into the femur.
Problems with the BHR System and R3 Acetabular Total Hip Replacement
Serious problems resulted from the metal-on-metal design of both products. While the BHR and other resurfacing designs were initially greeted with significant enthusiasm, especially for younger patients, serious concerns emerged regarding MoM joints, leading to increased scrutiny of these devices.
The metal surfaces of individual components in both products ground against each other during normal use, leading to metal erosion. This erosion released metal particles, including Cobalt and Chromium, into the patient’s bloodstream and surrounding tissue. These particles cause tissue and bone damage around the implant, with complications that include loosening of the joint and other failures.
This catastrophic design flaw has plagued all MoM designs irrespective of the manufacturer. To make matters worse, an elevated concentration of chromium and cobalt in the bloodstream can lead to metallosis.
Recall of BHR System and R3 Acetabular Total Hip Replacement
As a result of the premature hip implant failures and metallosis, Smith & Nephew issued a recall of the metal liner used in the R3 Acetabular Total Hip Replacement System in June 2012, the R3 System failed at a higher than normal rate forcing hundreds of patients to undergo painful revision surgery.
Similarly, after years of higher-than-expected failure rates and an abnormal number of cases requiring revision surgery, the manufacturer finally recalled the BHR System product in September 2015.
Some Smith & Nephew MoM hip devices have been reported to fail earlier than anticipated. A hip implant should ideally last for 15-20 years, but some patients with these devices require revision surgery much earlier.
Due to the failure problems, these revision surgeries are often more complicated than the original hip replacement because of bone loss, soft tissue damage, and other factors. This can lead to extended recovery times and increased risk of complications.
BHR and R3 Lawsuits
Several hundred lawsuits over Smith & Nephew’s BHR and R3 hip implants were filed in a multidistrict litigation (MDL) centralized in a Maryland federal court. As of October 19, 2023, there were 234 active lawsuits remaining in the MDL against Smith & Nephew’s BHR hip implant. Since the MDL opened in 2017, there have been 1,079 lawsuits filed.
Contact Dr. Shezad Malik Law Firm
If you or a loved one had a Metal on Metal Hip Implant listed above and have suffered injuries or needed premature revision surgery with the device, contact the attorneys at Dr. Shezad Malik Law Firm to learn more about your legal rights. You can speak with one of our representatives by calling 214-390-3189, or by filling out the case evaluation form on this page.
Our law firm’s principal office is in Dallas and we have offices in Fort Worth, Texas. Dr Shezad Malik Law Firm represents clients in dangerous drug and dangerous medical device lawsuits nationwide.
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