Author(s):

Melissa Hussey

Introduction:

Metal-on-metal (MoM) hip implants have been the subject of close media and regulatory scrutiny in recent months due to reports of soft-tissue damage and revision surgeries in some patients. Millennium Research Group’s new Physician Forum publication investigates physician opinions on these implants and whether recent bad press has affected their practice or clinical decision making.

• December 2009 — DePuy withdraws the ASR implant from the Australian market
• March 2010 — DePuy issues warning letter to physicians about the ASR acetabular cup; The New York Times publishes two high-profile articles about MoM implants and failure rates
• April 2010 — The Sunday Times publishes an article about UK failure rates of MoM; the UK Medicines and Healthcare products Regulatory Agency issues a Medical Device Alert for all MoM implants

Scope:

What Questions Will Physician Forum Help You Answer?

• How are physicians responding to increased negative press about MoM implants?
• Why do physicians currently use MoM? What do they see as advantages of the material?
• When physicians do not use MoM, what factors are involved in the decision?
• Will any doctors use MoM implants less in the future based on current events?
• Will the hip resurfacing segment face a negative impact due to spillover from the primary implant market?
• What do physicians think about my implant?

Key Sections: The following is an overview of the structure of the publication. The full publication contains 68 slides.

• Financial Impact of Survey Findings
  • Assumptions and Findings
  • Market Impact on Procedures and Revenues
• Commercial Context
  • Hip Degeneration Causes and Treatments
  • The Debate Over MoM (3 slides)
  • US Longitudinal Trends for MoM Primary Total Hip Arthroplasty (THA) Implant Procedures and Revenues
  • Outlook for the US MoM Primary THA Implant Market
  • Primary THA Implant Market Competitive Landscape
  • The Debate Over Hip Resurfacing Implants
  • US Longitudinal Trends for Hip Resurfacing Procedures and Revenues
  • Hip Resurfacing Implant Market Competitive Landscape
• Methodology
  • Survey Design
  • Regional Distribution
  • Physician Experience (3 slides)
  • Current MoM Implant Use
• Primary THA
  • Perception of The New York Times Article (3 slides)
  • Clinical Experience with MoM Implants: MoM Implant Complications
  • Primary THA Implant Usage (6 slides)
  • Material Selection
  • Clinical Experience with MoM Implants (5 slides)
  • Future Primary THA Implant Usage
• Hip Resurfacing
  • Hip Resurfacing Implant Usage (2 slides)
  • Hip Resurfacing Implant Brand Perceptions (3 slides)

Methodology: The survey explores physicians’ perceptions of the recent press on MoM implants, the expected impact on clinical practice in terms of implant choice, treatment mix and procedure volumes, and future market outlook.

• Hip surgeons (n = 148):
  • 99 general orthopedic surgeons
  • 33 total joint surgeons
  • 16 other surgeons

Participants in all groups are located throughout the US. The survey was conducted between April 30 and May 7, 2010.