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DePuy, England and Wales, Health, Hip Replacement, hip replacements, Medicine, Medicines and Healthcare products Regulatory Agency, metal, metal ions, MHRA, science, tiny fragments, University of Bristol
Metal on metal hip replacement, should you be concerned?.
Metal on metal hip replacement, should you be concerned?
Hip replacements are one of the biggest successes of modern medicine, reducing pain and improving mobility for patients. However, metal-on-metal hip replacements have recently come under wide scrutiny.
In 2010 the Medicines and Healthcare Regulatory Agency (MHRA) issued a safety alert for metal-on-metal hip replacements, advising that operations should be followed by a check-up after five years.
When successful, this implant can provide years of trouble-free use with lower levels of wear and tear than other materials. They also allow for much larger femoral heads to be used in the implant, resulting in a larger range of hip movement and greater stability, making dislocation less likely. Metal-on-metal hip replacements are still being used, although numbers in the UK have fallen significantly from 8,072 in 2008 to 673 in 2011.
While most cause no problems, there are a minority that can be dangerous. Research carried out at the University of Bristol analysing information from 402,051 operations in England and Wales found that 6.2% of metal-on-metal hip replacements failed within five years – three times higher than metal-on-plastic or ceramic-on-ceramic alternatives.
If they fail, they can produce particles of cobalt and chromium, triggering a reaction that can cause erosion of the bones and potentially loosen the implant. Furthermore in March 2012, the MHRA said some patients should have annual blood tests as these tiny fragments of metal could leak into the blood and cause muscle and bone damage as well as neurological issues.
Usually, any metal ions absorbed into the bloodstream are filtered out by the kidneys into the urine, but blood tests can identify whether the concentration of ions is dangerous. It’s vital to have a blood test if you are one of the 49,000 affected patients in the UK.
Patients who have received either a DePuy ASR or ASR XL hip replacement should have been contacted by their hospital or GP already following the recall in 2010. Many manufacturers are covering the cost of any investigations and treatment to rectify the problem but for others legal compensation can be sought.
National law firm Linder Myers specialises in medical negligence cases including metal on metal hip replacements.
Related articles
- ‘Toxic’ hip replacement fears – UK Health News – Isle of Man Today (earlsview.com)
- ‘Toxic’ hip replacement fears – Health – Belfast Newsletter (earlsview.com)
- Stryker Orthopedics Recalls Metal Hip Implant Components (earlsview.com)
- No cancer rise in hip implant patients – Health – Fleetwood Weekly News (earlsview.com)
- Troubled Hip Implants Require Additional Patient Monitoring | Goldberg & Osborne (earlsview.com)
- Smith And Nephew Hip Replacement Recall Lawsuit Attorney (earlsview.com)
- Failure rates of stemmed metal-on-metal hip replacements : The Lancet (earlsview.com)
- Pennsylvania woman to address FDA panel on husband’s hip-replacement recall – Philly.com (earlsview.com)
- Biomet M2a Magnum Metal-on-Metal Hip Replacement Lawsuit (earlsview.com)
- About Metal-on-Metal Hip Implants (earlsview.com)
Earl's View 
Guide From NHS
Worries over metal-on-metal implants
There have been cases of some metal-on-metal hip replacements wearing sooner than would be expected, causing deterioration in the bone and tissue around the hip. There are also concerns that they could leak traces of metal into the bloodstream.
The Medicines and Healthcare products Regulatory Agency (MHRA) has issued new guidelines that larger types of metal-on-metal (MoM) devices should be checked every year while the implant is in place. This is so that any potential complications can be picked up early.
If you are concerned about your hip replacement contact your GP or orthopaedic surgeon. They can give you a record of the type of hip replacement you have and tell you if any follow-up is required.
You should also see your doctor if you have:
•pain in the groin, hip or leg
•swelling at or near the hip joint
•a limp, or problems walking
These symptoms do not necessarily mean that your device is failing, but they do need investigating.
Any changes in your general health should also be reported, including:
•chest pain or shortness of breath
•numbness, weakness, change in vision or hearing
•fatigue, feeling cold, weight gain
•change in urination habits
For more information read our metal-on-metal implant advice Q&A.
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