5th March 2012
Patients with large head, ‘metal-on-metal’ hip replacements will need to be annually checked for complications for as long as their implants are in place, according to the most recent advice from the Government’s health regulator.
Approximately 49,000 patients in the UK have this type of hip implant. Other patients, whose hips have ceramic or plastic components or smaller metal heads, will not be affected by the new advice.
There is evidence that small particles of metal, in particular chromium and cobalt, can be released into the tissues surrounding the hip when the ball and socket of a metal-on-metal hip joint rub together during use. This metal debris can cause inflammation, damage to muscle tissue and bone and may enter the bloodstream. The metal-on-metal joints have also been found to wear down at a faster rate than other types.
The MHRA (Medical and Healthcare Products Regulatory Agency) has issued advice to doctors and surgeons that all-metal implants carry a risk of complications and patients should have blood tests each year, to screen them for elevated levels of metals in their blood. If raised levels are detected, or if they are suffering problems, they should undergo MRI scans. Implants that have failed may need to be removed and replaced.
An investigation carried out by BBC Newsnight and the British Medical Journal reported that the risks posed by metal-on-metal implants have been known for some time, but they were not taken out of use.
The ASR metal-on-metal implants manufactured by DePuy, a subsidiary of Johnson & Johnson, were recalled in 2010. DePuy are now facing legal action from patients who received ASR implants and they have set aside funds in case they are required to pay out compensation.
Other all-metal implants however, including DePuy’s Pinnacle hip and similar devices made by companies such as Smith & Nephew, are still on sale and in use.
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