THE YOU DOCS Q&A

Worried about a metal hip replacement?


Published: Tuesday, January 31, 2012 at 6:01 a.m.
Last Modified: Friday, January 27, 2012 at 10:50 a.m.

Q. My 81-year-old mom had a hip replacement about 15 years ago. Now she complains of pains in her legs. I've heard horror stories about these replacements failing. Could this be the source of her problems?

Catherine W.

A. Like bionic creatures from the future, millions of us are walking, swimming even waltzing around with hip implants.

We YOU Docs suspect you're worried because you've heard about the recall of some metal on metal hip implants, especially those made by DePuy. While recalls and lawsuits are going on, in fact only a small fraction of the more than half a million people in North American who've gotten all-metal hip implants during the past decade have suffered injuries from the devices. For the vast majority, these replacement parts make day-to-day living a lot more enjoyable and pain-free.

If possible, contact your mom's surgeon to see if she got a DePuy ASR. Meanwhile, look for these typical signs of problems with metal-on-metal implants: pain in the groin, hip or leg; swelling around the hip joint; and a limp or trouble walking. If your mom has these symptoms — she clearly has leg pain — her doctor can run imaging, joint and blood tests (checking for metal ions) to see if the problems come from the metal parts in her body.

Alternatively, it simply may be time to replace the replacement. At the time she got her hip implant, these artificial joints were projected to last about 15 years (today's may endure for 30 years). Your mom's hip replacement might just be closing in on its expiration date, meaning it's time for a new one.

But if her pain is in both legs and she had a replacement in only one, it most likely isn't the replacement, but another issue. So get her to an internist, and make sure it isn't some other issue that's easier to resolve.

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Q. I have diabetes and an open sore on the outside of my foot that will not heal. My doctors mentioned using maggots to try to heal the wound. I know I'm running out of choices, but are they serious?

Steven S.

A. Dead serious. Dead-tissue serious, that is. If you're worried that opting for this scary-sounding treatment will cast you in a starring role for a remake of the movie "The Fly," don't be. Medical maggots (fly larvae) won't take over your body. They're completely disinfected, sterile and only interested in dining on dead tissue around a wound — which encourages new, healthy tissue to grow in its place.

You may have a treatment a couple of times a day or receive a "dressing" that stays on for 24-48 hours. In both cases, 30-50 larvae are sealed tightly against each square inch or so of the wound. Usually you can't feel anything, unless exposed nerves in the wound are already causing pain. Then you may feel the creatures' movements, but pain relievers should take care of that.

Don't imagine that these tiny, squirmy critters will burrow anywhere they shouldn't. Once they're done helping you heal, all they want to do is get on with the business of turning into a fly. Unfortunately for them, when they've completed their medical mission, they're treated just like any other medical waste and are quickly disposed of.

This larvae-lunch therapy helps heal bedsores, surgical wounds and diabetic ulcers, which is what yours sounds like. Diabetes can foster festering wounds because poor circulation hinders healing, and nerve damage can let sores appear without any pain. If the wound won't heal, it can lead to amputation of a toe, foot or leg. But maggot therapy, approved by the Food and Drug Administration in 2004, could put you back on the dance floor.

So learn to love the healing powers of these baby bugs.

The YOU Docs, Mehmet Oz, host of "The Dr. Oz Show" and Mike Roizen of Cleveland Clinic, are authors of "YOU: Losing Weight." For more information go to www.RealAge.com.

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