On the Move
To say that Marblehead resident and kindergarten teacher Debra Geaney, 63, is an active woman would be an understatement. A former collegiate gymnast, she has enjoyed athletic pursuits over the years, including ski racing, triathlons, biking, spinning, golfing and even piloting planes.
So it’s even more surprising that just bending down to get on her students’ level caused so much pain in her hips that she was changing her daily routine and thinking about her future with limited movement. “I started avoiding stairs and thinking that we might have to sell our house and move to a one-level home,”says Geaney.
It also landed her in the middle of an emerging medical device controversy—the ongoing safety of metal-on-metal (MoM) hip replacements, which has resulted in device recalls, class action lawsuits and publicity about the issue. Her struggles with hip pain began in the fall of 2006 when she was practicing emergency procedures in her multi-engine airplane. “I was working on single-engine stalls, which required me to push the rudder pedal full force with one leg to keep the plane flying on course,” she explains. “After I landed, my right hip felt sore when I walked. Within a few days, I was experiencing a lot of pain in that hip and started to limp.”
Geaney went to NSMC Chief of Orthopedics William Murzic, M.D.,who diagnosed arthritis and recommended physical therapy.
After two months, however, the pain not only lingered but intensified. Dr. Murzic ordered a new X-rayand was surprised to see how quickly the hip joint had deteriorated. He performeda right hip replacement using a metal-on metal implant in May 2007. After recuperating, Geaney went back to work and was eager to get back to golfing when she started having pain in the left hip. Again, Dr. Murzic noted very rapid deterioration of the joint and replaced it in November 2007. “After my initial recovery, I was pain free,” says Geaney. “I returned to riding my bike, working out on the elliptical machine and, finally, golfing again.”
During her annual follow-up visit in 2011, Dr. Murzic told her about certain metal-on- metal hip devices that were under scrutiny for failing to perform as well as others. She also learned that, in fact, she had a metal-on-metal hip implant, but not the one that was being recalled. As a precaution, Dr. Murzic ordered a blood test to measure the metal ion levels in her blood, an indicator of excessive wear on the implant. “My blood levels were elevated, but because I wasn’t experiencing any pain, we decided to continue to monitor it,” says Geaney.
A few months later, Geaney began experiencing pain again. She went back to Dr. Murzic, and another blood test revealed even higher levels of metal ions. She also had a special MRI that showed cysts in the muscles surrounding the hip replacement, indicating that the device was failing. In April 2012, Dr. Murzic preformed revision surgery on both hips, replacing the metal liner on the socket of the joint with a polyethylene version. Two short months later, she was pain free and keeping up with her husband and young grandchildren at Disney World.
“The device recall has had orthopedic surgeons the world over monitoring their patients carefully for any changes,” says Murzic. “Most patients will continue to do well, but a few, like Debra Geaney, will need revision surgery. The key is close monitoring.”
Despite her complications, Geaney is grateful for the care she has received. “We’re really lucky to have such a great network of physicians locally. When I needed surgery, I knew I could get great care at NSMC,” says Geaney. “As you get older, you often have more medical issues, and it’s so reassuring that NSMC and Partners has such a broad network of specialists available to us.”