Examining the ethical implications of an orthopaedic joint registry.

R.P., a fifty-seven-year-old man, underwent a total hip replacement with a newly designed, cementless hip system. Within the first several months after surgery, he had persistent thigh pain. Radiographs made at one year indicated progressive radiolucent lines surrounding the femoral component. He required revision surgery for aseptic loosening of the femoral component. Several months following the revision, a single journal article indicating a similar problem at another institution with the same device was published. A year later, two additional articles appeared in the literature. One year later, the femoral device originally implanted in R.P. was removed from the market.