In 2010, the UK Medicines and Healthcare Regulatory Agency (MHRA) issued three safety alerts, one for metal-on-metal hips and two for ASR (Articular Surface Replacement) hips.
Since these alerts the MHRA are advising that all metal-on-metal hip patients should be followed up annually for 5 years and all ASR or ASR XL hips (models which have now been withdrawn) should be followed up annually for the life of the implant. Patients who have a hip replacement with a 36 millimetre or larger head should be monitored once a year for the life of the replacement.
Our surveillance package
Our surveillance package comprises of a one-stop clinic including;
- A consultation with an Orthopaedic Consultant or specialist Nurse
- Blood tests where needed
- Appropriate imaging
What is involved in metal on metal surveillance?
If you are not in any pain or having any problems then a yearly telephone conversation or questionnaire may be all that is required. Your Consultant or another practitioner usually carries this out.
If you are having issues with the replacement, such as pain and discomfort you will need a more detailed assessment. This may include a physical examination, blood tests to measure the concentration of metal in the blood and possibly an MRI or ultrasound scan.
Damage to hip replacement
If you are not experiencing any pain, it may not be due to the reaction to metal debris in the body. Wear, loosening and infection are all causes of pain for all types of hip replacement.
If there is damage to the hip then revision surgery may be required.
Are these still being used?
Metal-on-metal hip joints are still being used. It is the only way to perform a resurfacing operation where the thighbone is capped. There is some evidence showing that in men under 55, or men who are very active, some metal-on-metal resurfacing replacements give equal or slightly better results than a total hip replacement.
However, the use of metal-on-metal hips has greatly reduced in the last 2 years.