Metal on metal hip replacement and resurfacing
Published on 11 January 2012
Health regulators have launched an investigation into the safety of metal-on-metal hip replacements after fears that they could cause long-term complications.
The Medicines and Healthcare products Regulatory Agency is investigating the potential long-term toxicity of metal-on-metal hip replacements.
Problems with metal on metal hip replacements can occur when friction between the metal ball and the cup causes tiny metal filings to break off and potentially seep into the blood.
Arthritis Research UK has been funding research on possible biological effects or contamination of the body through absorption of metals from the implant. The precise clinical implications are not certain at the moment and further research is needed.
The MHRA has advised that all patients with metal on metal hip replacements should have annual check-ups and be followed up for five years.
A spokesperson from the MHRA said: “On the evidence currently available, the majority of patients implanted with metal-on-metal hip replacements are at low risk of developing any serious problems.
“We are continuing to closely monitor all evidence. This needs more analysis before any conclusions can be drawn and further advice given. We have already taken prompt action to investigate safety concerns.”
The MHRA added that those experiencing pain should be tested for levels of cobalt and chromium in their blood and an MRI or ultrasound scan to check for soft tissue reactions.
The MHRA is working closely with the England and Wales National Joint Registry, the British Hip Society and the British Orthopaedic Association to review relevant safety information as it arises and will take action to provide further advice with people with implants if they identify the need.
Most hospitals will have contacted patients with a metal-on-metal hip, but anyone with outstanding concerns should contact their GP or hospital department.
If you are uncertain whether you have a metal on metal hip replacement, and you signed a consent form for details of your operation to be sent to the National Joint Registry you can contact them directly to find out the details of your implant. They can be contacted on 0845 3459991 or email health_servicedesk@northgate-is.com
Following recent concerns about metal-metal hip joint replacements in the media Arthritis Research UK has produced a Question and Answers document for people who need more information.
Update February 28: The MHRA has updated its advice on follow-up of metal-on-metal hip replacements. Patients with a particular type of MoM hip replacement - with a head diameter of 36 millimetres or more - should be monitored annually for the life of the implant, rather than for five years only. Monitoring advice for patients with other types of MoM hip implants, including those with a head diameter smaller than 36 millimetres, and metal-on-metal hip resurfacing, has not changed.
Read our Q&A on metal on metal hip replacement.
Read some of the recent stories on hip resurfacing and hip replacement below: