DePuy, a Johnson and Johnson company, announced on August 26, 2010, the recall of one of their shell head designs sold in the United States. This particular design accounted for a very small percentage of the total hip business of DePuy Orthopaedics. The shell had a higher than expected failure rate at mid-term followup, and therefore DePuy felt it appropriate to withdraw this implant from the market. We have been involved in a clinical study evaluating the ASR-XL cup. To date we have had no failures. The cup is technically more difficult to put in as there is no ancillary fixation typical of this family of monoblock acetabular components. Consequently if rigid stability is not obtained, there is a possibility of fibrous ingrowth and failure of fixation.
Patients who have a solidly ingrown ASR-XL shell should expect lasting function from this particular implant. It does utilize metal-on-metal technology which will require further evaluation to determine the exact nature of adverse tissue reaction, with this type of implant Which have been reported to occur in 1-2% of cases.
— William P. Barrett, MD
