Sales Dip for Stryker Following Hip Implant Recalls

Stryker sales have shown a definite dip in the quart since the recall of the Stryker Rejuvenate and ABGII hip implants in July. The hip implant recall came just months after Stryker issued an Urgent Field Safety Notice to hospitals and physicians in April of 2012 citing the potential of fretting and corrosion at the neck juncture as well as the risk of metal ion release. Stryker’s hip implant sales dropped nearly 10 percent while its knee implant sales dropped 4.3 percent.

Why the Dip in Revenues?

A Stryker company official stated the recalls of the Rejuvenate and ABGII had only a “modest impact” on the company’s third quarter drop in sales. While the recalls certainly would have impacted Stryker’s revenues, the overall economy may also have played a part. Joint replacement surgical procedures are considered elective most of the time. Those with insurance may delay the surgery to avoid missing work while those without insurance likely cannot afford the procedure. Stryker’s CFO, Curt Hartman also stepped down after two decades at the helm. He reportedly received a 1.5 million dollar separation package although he will remain as an adviser to Stryker through February, 2013. 

Why Diagnosing Problems in Stryker Rejuvenate Hip Implants is So Difficult

When the Stryker Rejuvenate and ABGII were recalled in July of 2012, citing potential risk of fretting and corrosion at the neck juncture, many of the implants had already been removed during revision surgeries. Unfortunately, since most physicians were unaware of the problems with the implants, the operative reports were unlikely to list this corrosion. In other words, since the doctors hadn’t been told what issues to look for, there were few records stating that corrosion was a factor in the revision surgery. When Stryker originally told hospitals and surgeons (in an Urgent Field Safety Report in April of 2012) that there could be corrosion or fretting and release of metal ions, there was still no mention of that corrosion occurring anywhere except at the neck juncture.

Therefore, the neck juncture would likely have been the only place physicians would have examined when taking out the implant. In the same vein, when implant recipients came to their doctor complaining of pain or other symptoms, the doctor would have ordered x-rays, an MRI and a bone scan. Again, without clear information regarding what to look for, many physicians might have attributed their patient’s complaints to external issues such as the aging process.  The Rejuvenate, unlike former metal-on-metal hip implants, is a four-part device with a ceramic ball and a plastic liner in the cup. Because of these improvements, it was believed there would be no metal parts rubbing against one another causing metal ion shear. 

Stryker Rejuvenate Hip Implant: What is the Real Problem?

Just this past July Stryker Orthopedics issued a voluntary recall of their Rejuvenate and ABGII hip implant systems citing a potential for fretting and corrosion at the metal neck junction. The FDA convened a panel shortly before this recall to discuss the merits of continuing to use metal-on-metal hip implants due to the high number of complications suffered from recipients. The design of the Rejuvenate was believed to overcome most issues associated with the all-metal hip implants as it allowed surgeons to custom-fit the stems and necks of the implants to the size and relative activity level of the patient.

The Rejuvenate Design

The Stryker Rejuvenate consists of a ceramic ball which fits into a plastic-lined socket. Because there was no metal-on-metal ball and socket it was believed there were no metal surfaces which could potentially rub against one another, causing metal ion debris to enter the surrounding tissue or bloodstream. The Rejuvenate is essentially a two-piece system in that the properly sized metal stem and neck connect to one another then connect to the ceramic ball. The neck is made of chromium and cobalt, just like the all-metal implants and the stem is coated with titanium. Even so, by using a ceramic ball and a plastic-lined socket, it was believed there would be no issues regarding metal ion debris.

Motorcycle Accidents in the State of Texas

As motorcycle riding has grown in popularity over the past decade it might surprise some to realize that a large portion of these additional motorcyclists are comprised of the “over-fifty crowd.” Contrary to the stereotype of the motorcyclist who drives recklessly and too fast, this group of motorcyclists generally drive their bike in the same manner they drive their automobile—safely and respectful of the other drivers on the road.

Texas Motorcycle Facts

Although the nation has seen a decline in the overall number of motorcycle fatalities, the state of Texas has actually had an increase in motorcycle deaths, with the majority of these deaths occurring in those between the ages of 20 and 29. It can be traumatic for anyone involved in an accident of any type however those who are injured in a motorcycle accident are much more likely to suffer death or serious injury.  There is little to no protection for the motorcycle rider when he is hit by a three-thousand (or more) pound hunk of metal, steel and glass.

What Happens Following a Trucking Accident?

There are nearly half a million collisions involving large commercial trucks each year; as many as 5000 of those involve fatalities with the state of Texas having between 250 and 450 trucking fatalities annually. In fact, the fatal crash rate for large trucks is 2.4 deaths per 100 million vehicle miles traveled which is fifty percent higher than the rate for other vehicles on the road. Because of the great disparity in size between a loaded commercial truck and a passenger vehicle 98 percent of these trucking fatalities are occupants of the smaller vehicle. A normally loaded 18-wheeler can take up to 350 feet to come to a stop while an overloaded truck will take an even longer distance.

Factors in Trucking Accidents

Trucking accidents are the result of a variety of factors including truck driver error, distraction or fatigue, mistakes on the part of the driver of the passenger vehicle, and mechanical failures which are common to 18-wheelers. The scores of victims of trucking accidents may wonder how the system which is meant to keep us safe has failed time after time. Those who survive a trucking accident likely find themselves totally immersed in the health of those involved in the accident, particularly in instances where injuries are extremely serious. The focus is on medical care and the ongoing treatments required leaving little time or energy to contemplate the medical bills stacking up, the lost wages which are resulting in regular bills going unpaid and the long-term effects resulting from the trucking accident. Those involved in a trucking accident may have wondered what the “other side” was doing in the days and weeks following the collision.

When Trucking Accidents Occur in the State of Texas

The City of Houston is well-known for the number of large commercial trucks which share the roadways with other vehicles. Because the Houston area is a primary shipping route, with over three million residents in Houston and outlying areas, it is considered one of the busiest thoroughfares in America. There is also considerable truck traffic resulting from the surrounding petroleum-transport areas as well as the many 18-wheelers from out of state which continuously travel through the Houston area. When you factor in the amount of truck traffic in the area you can see that accidents are much more likely to happen simply due to the sheer volume of truck traffic.  In 2008 Houston saw 421 fatalities involving large commercial trucks and although that number was down to 284 fatalities by 2010, the numbers are still sobering.

Why 18-Wheelers are Dangerous to Smaller Vehicles

The Houston area accounted for approximately 8 percent of all fatalities associated with trucking accidents in the entire United States. Considering the sheer size of an 18-wheeler—particularly when it is fully loaded—in the event a truck crashes into a passenger vehicle, those in the smaller vehicle are obviously at a clear disadvantage. Even though trucks are now required to have under-ride bars at the rear, when a passenger car runs into the back of an 18-wheeler the impact is four times as likely to cause death than when the reverse is true (when the 18-wheeler rear-ends a passenger vehicle). A loaded truck easily weighs 20-30 times as much as a passenger vehicle meaning it takes a good forty percent longer distance to come to a complete stop. In the end, when an 18-wheeler collides with a smaller vehicle it is highly likely there will be serious injuries or death.

When Truckers Take to the Road Do They Look Out for Your Safety?

You’ve probably noticed drivers who are texting, talking on their phones, applying makeup, eating, or any number of other activities which distract them from driving and put other drivers and passengers at risk. Now, imagine that person who is not paying attention to the road is a truck driver. When you consider that a fully loaded truck needs the length of a football field to come to a complete stop—assuming it is traveling 60 mph on a totally dry road--you can see that when a truck driver is distracted, even for a moment, a tragic accident can result. The most recent federal regulations mandate shorter braking distances for commercial trucks however don’t affect existing 18-wheelers, only newly manufactured trucks.

While all drivers should avoid distractions which can lead to accidents, there is a large disparity between a crash between passenger vehicles and a crash involving a commercial truck and a passenger vehicle. A fully loaded truck is 20-30 times as heavy as a passenger vehicle and in a collision between the two the passengers in the smaller vehicle rarely fare well. Of the half a million trucking accidents in the United States each year approximately 5,000 of those will result in fatalities and a large percentage of the remainder will result in very serious injury to those in the passenger vehicle. Truck drivers are constantly under pressure to get their loads delivered; both from their employers and even from their own family members as their paycheck depends on the time they spend behind the wheel of the truck.