ALVAL from Hip Replacement: Symptoms and Treatment

It’s almost unthinkable. The hip replacement surgery that once brought you great relief and improved mobility is now becoming painful and debilitating. How could this happen again? It probably seems unfair that after going through surgery and rehabilitation, you’re feeling worse than before. It can be overwhelming and frightening to think about what exactly went wrong, your chances of recovery, and what to do next.

If you have a metal-on-metal hip replacement, it may be the source of the trouble.  In particular, ALVAL, a painful, incapacitating condition, has been linked to metal-on metal models, such as those made by DePuy, Zimmer, and Stryker. Many patients have had to undergo hip revision surgery to have their metal hips removed and replaced with safer models. As a result, several replacement hip manufacturers have recalled their all-metal hip replacements.

What Does ALVAL Mean?

ALVAL is short for “aseptic lymphocyte dominated vasculitis-associated lesions.” The problem is not caused by any outside infection. Instead, continued wear of metal-on-metal parts in the artificial hip results in the release of metal debris into the surrounding tissues. The metallic particles create a very dangerous hyper-sensitivity reaction or abnormal immune response, resulting in ALVAL.

ALVAL can cause inflammation, fluid, and psuedotumors (tumor-like lumps) to develop around the affected hip joint. As a result, critical blood vessels and muscles can be completely destroyed, resulting in grave disability or even death.

What Are the Symptoms of ALVAL from Hip Replacement? 

You may not notice any problems with your hip replacement, even if there is damage occurring. As a result, the FDA advises patients with metal-on-metal hips to have periodic exams (every 1 to 2 years) to monitor the stability of the hip area. However, most patients with ALVAL from hip replacement do have noticeable problems, including:

Early symptoms are:

  • Pain in the groin
  • Swelling and inflammation in the affected hip
  • Lumps in or around the groin or hip area

Late symptoms are generally associated with advanced tissue damage or joint dislocation.       They include:

  • Inability to bear weight on the affected leg/hip
  • Extreme pain of the hip, leg, and groin
  • Tendency of the affected leg to turn inward

Call a medical professional immediately for any of the above symptoms. The late symptoms are considered a medical emergency.

What Tests Can Detect ALVAL?

Your doctor may order a number of tests to determine if any problems you have are related to ALVAL. These tests may include:

  • A complete physical and localized assessment
  • Ultrasound
  • MRI
  • Fluid testing from areas around the affected hip
  • Blood testing for white blood cells and metals (chromium and cobalt)

Treatment and Next Steps for ALVAL from Hip Replacement

As the treatment for ALVAL associated with faulty hip replacement is most commonly a revision or complete hip replacement, the costs can be astronomical.  Along with additional surgery, the patient will probably undergo hospitalization, missed work, and extensive physical therapy.  Fortunately, many patients are able to recover these costs from the manufacturers of their metal-on-metal hip implants with the appropriate legal representation.

If your doctor feels that you’ve suffered ALVAL from hip replacement surgery, some detective work may be necessary.  You should request a copy of your medical records to determine the exact hip model you received. In addition, you may want to contact an attorney to learn more about your legal options.