Lifelong checks for metal hip implant patients

March 1, 2012

The UK government's health regulator has advised new checks for patients who have undergone large head metal-on-metal hip replacements, following a major investigation by Newcastle University engineers.

The new advice follows a report triggered by the work of Newcastle University expert Dr Tom Joyce who first exposed the problems associated with the implanted devices.

All-metal hips have a high failure rate and rubbing between the ball and cup can cause metal to break off, seeping into tissue and causing complications.

But despite the fact that the risks posed by these minute pieces of metal have been known and well documented for decades, have been kept in the dark.

The new claims could mean that more people are affected by the dangers of metal hip replacements than suffered in the recent PIP breast implant scandal. It means 49,000 people will now need annual tests to check their blood ion levels.

The joint investigation by the British Medical Journal (BMJ) and BBC Newsnight showed how metal ions can seep into the tissues of patients with metal-on-metal hip implants, causing reactions that destroy muscle and bone, and leaving some patients with long term disability.

Newcastle University’s bioengineering team led by Dr Joyce began investigating the problem of metal hips as far back as 2008 and raised concerns about the health risks to patients.

Criticising the Medicines and Healthcare products Regulatory Agency (MHRA), Dr Joyce said it took the regulator four years to recall from the market articular surface replacement (ASR) hips following mounting evidence about the dangers posed to patients.  ASRs were eventually recalled in 2010.

Dr Joyce said: “The MHRA are meant to be on the side of patients but they have not been neutral and have had too cosy a relationship with the notifying bodies and manufacturers.

“The MHRA seem to have tried to shy away from the issue – why have they not felt in a position to do anything?

“Since the replacement hips were withdrawn in 2010 nothing has changed and the entire system has seriously failed patients. There needs to be a lot more transparency in the system.”

Hip implants, like breast implants, did not have to pass any clinical trials before they were put into patients.

The report tells how the implants’ metal ions can seep into the bloodstream, spreading to the lymph nodes, spleen, liver and kidneys, before leaving the body as urine. Concern has also been raised about damage to chromosomes, leading to genetic changes.

Their investigation also shows how companies have changed the design of their metal hips over the last decade in a bid to prevent dislocation and increase movement, without conducting new trials to demonstrate their safety.

New guidance was issued yesterday by the MHRA over metal implants, and patients who have undergone large head metal-on-metal hip replacements should be monitored annually for life. The MHRA said there was a “small risk” the implants could cause complications in patients.

It means some 49,000 people in the UK whose hip replacements have a head diameter of 36 millimetres or more will now need annual tests to check their blood ion levels.

Dr Susanne Ludgate, Clinical Director of the MHRA, said in a statement: "Clinical evidence shows that patients have a small risk of suffering complications from having metal-on-metal hip implants.

"As a precautionary measure, we have today issued updated patient management and monitoring advice to surgeons and doctors that they should annually monitor patients for the lifetime of their metal-on-metal total hip replacements that are sized 36 millimetres or more because this particular type of has a small risk of causing complications in patients."

Explore further: UK says metal hip replacements more troublesome

Related Stories

UK says metal hip replacements more troublesome

September 16, 2011
(AP) -- People who get metal hip replacements are more likely to need a replacement compared to those who get a traditional plastic one, according to a new report from a large British registry.

New hip implants no better than traditional implants

November 30, 2011
New hip implants appear to have no advantage over traditional implants, suggests a review of the evidence published in the British Medical Journal today.

'Hundreds of thousands' fitted with suspect hip implants

February 28, 2012
Hundreds of thousands of people have been fitted with replacement hips whose flawed design may be exposing them to toxic metal, according to a probe by the BBC and the British Medical Journal (BMJ) unveiled Tuesday.

Archive of failed joint replacements provides tips to building a better hip replacement

February 8, 2012
A study by Hospital for Special Surgery researchers has provided the first comprehensive look at just how metal-on-metal total hip replacements are failing in patients around the country. Made possible by what is thought ...

Skin tests catch metal sensitivity before joint replacement

February 24, 2012
(HealthDay) -- Testing patients for metal hypersensitivity before they receive joint or bone implants helps identify those at increased risk for complications due to metal hypersensitivity, a new study shows.

Recommended for you

Exploring the potential of human echolocation

June 25, 2017
People who are visually impaired will often use a cane to feel out their surroundings. With training and practice, people can learn to use the pitch, loudness and timbre of echoes from the cane or other sounds to navigate ...

Team eradicates hepatitis C in 10 patients following lifesaving transplants from infected donors

April 30, 2017
Ten patients at Penn Medicine have been cured of the Hepatitis C virus (HCV) following lifesaving kidney transplants from deceased donors who were infected with the disease. The findings point to new strategies for increasing ...

'bench to bedside to bench': Scientists call for closer basic-clinical collaborations

March 24, 2017
In the era of genome sequencing, it's time to update the old "bench-to-bedside" shorthand for how basic research discoveries inform clinical practice, researchers from The Jackson Laboratory (JAX), National Human Genome Research ...

The ethics of tracking athletes' biometric data

January 18, 2017
(Medical Xpress)—Whether it is a FitBit or a heart rate monitor, biometric technologies have become household devices. Professional sports leagues use some of the most technologically advanced biodata tracking systems to ...

Financial ties between researchers and drug industry linked to positive trial results

January 18, 2017
Financial ties between researchers and companies that make the drugs they are studying are independently associated with positive trial results, suggesting bias in the evidence base, concludes a study published by The BMJ ...

Best of Last Year – The top Medical Xpress articles of 2016

December 23, 2016
(Medical Xpress)—It was a big year for research involving overall health issues, starting with a team led by researchers at the UNC School of Medicine and the National Institutes of Health who unearthed more evidence that ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.