Your Weekly Checkup: Medical Device Malfunction or Degeneration

“Your Weekly Checkup” is our online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive. 

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Now that I’ve reached the ripe old age when I can leave my shoes on while traversing airport security screening, the TSA agent always asks before I enter the metal scanner, “Any device implants?” Thankfully, I am able to say no: all my body parts are still original.

According to a recent article, that’s not true for about 32 million Americans (1 in 10) who have at least one medical device implanted. Inserts range from simple items like eye lenses or birth control devices, to complex objects such as cardiac stents, pacemakers, defibrillators, and heart valves.

Creating an implant that can weather the body’s hostile internal environment over a long time period is a major challenge. Manufacturers must replicate the years of toxic impact the body exerts on an implant to be certain the device performs as it should, often for many decades. Even minor changes to a “tried and true” implant can sometimes be disastrous.

Hip implants are a case in point. Degeneration of the hip bone and joint from arthritis or injury can lead to pain, stiffness, and difficulty walking, often requiring total hip replacement. One type of implant is metal-on-metal in which the ball and socket of the device are both made of metal. Walking or running causes the metal components to rub against each other, eventually eroding the surfaces and causing tiny metal pieces to implant in the neighboring tissues. Some of the metal ions can enter the bloodstream to elevate cobalt, nickel, or chromium levels.

Patients often respond to these changes differently. Some experience no symptoms while others have an adverse reaction to the metal debris damaging the soft tissue surrounding the implant; they experience pain, loosening of the implant, and eventual device failure. The changes can impact general health, affecting nerves, heart, kidneys and thyroid. Some companies have recalled specific types of devices. The FDA states that, “All hip implants will need to be replaced eventually, and implant longevity is influenced by a patient’s age, sex, weight, diagnosis, activity level, condition of the surgery, and the type of implant.”

The purpose of this column is to call attention to implants that may not be functioning as optimally as they did after insertion. Patients experiencing new symptoms should not just “tough it out,” but should contact their health care professional promptly for evaluation. The problem may be trivial, requiring a minor adjustment, or significant, requiring device replacement.

If you are that patient, do not put off your checkup.