Court-ordered mediation has resulted in settlements in 20 of 21 cases against Stryker Rejuvenate metal-on-metal hip replacements, according to the New Jersey state court handling the litigation in a multi-county litigation.

Small groups are meeting in an attempt to settle the hip implant lawsuits. So far, 21 metal on metal hip implant lawsuits have gone through the mediation program. There are some 4,000 pending Stryker metal hip lawsuits filed in both state and federal courts alleging problems with the Stryker Rejuvenate or ABG II hip replacement systems. Both were recalled in 2012 after reports that the hip replacements quickly corroded and failed.

Some 2,000 of the Stryker metal hip implant lawsuits are in New Jersey state court, the U.S. headquarters of Stryker Rejuvenate.

The remaining 2,000 hip replacement lawsuits have been consolidated in a federal multidistrict litigation (MDL). The federal court has assigned a single judge for all pretrial proceedings. Having one judge reduces duplicative discovery and avoids conflicting rulings from different judges. It also is more convenient for the parties and witnesses.

With two pieces instead of a single piece, the Stryker metal hip replacements allowed surgeons to customize the length of the femoral component. But the allegedly defective design has resulted in microscopic metal debris being released by the implant’s chromium-cobalt neck rubbing against the titanium femoral stem.

In 2012, Stryker recalled the Rejuvenate Modular and ABG II Modular-Neck Hip Stems and discontinued sales and production worldwide.

The company had issued an “Urgent Field Safety Notice” to implant surgeons and hospital risk managers months before the recall, warning of possible dangers including corrosion and “fretting,” which allows minute shards of its metallic components to enter a patient’s tissues, bones and bloodstream.

Before the recall, Stryker sold approximately 20,000 hip implants. It is anticipated that problems from the implants will cause patients to suffer “catastrophic failure” from the hip implant the longer it remains in the body.

Metal hip implant side effects to be aware of include a dislocated hip, leaking of toxic substances such as chromium or cobalt, cancer, degenerative heart disease, loss of bone strength, resulting in bone fractures, tissue death on areas surrounding the implant, non-cancerous tumors around the hip implant, cobalt poisoning or metal poisoning caused by chromium or cobalt particles leaking into nearby tissue or the bloodstream.

Patients who have a Stryker metal hip implant are expected to need risky revision surgery to replace the device.

In November, Johnson & Johnson agreed to pay $2.5 billion to settle about 8,000 metal on metal hip implant lawsuits.