We will keep you posted as to updates and developments within the area of hip replacement and surrounding litigation.
No increased risk of cancer with metal on metal hip replacements
People with metal-on-metal hip replacements do not have an increased risk of cancer during the first seven years after they receive the device, according to a new study.
However, a longer-term study should be done, researchers at the Universities of Bristol and Exeter in the U.K. report.
They examined data from the National Joint Registry of England and Wales, which contains records on more than 1 million hip replacement procedures. The researchers compared cancer rates in patients with metal-on-metal hip replacements, patients with hip replacements made with other materials, and the general population.
The chance of a 60-year-old man with moderate health and a metal-on-metal stemmed hip replacement being diagnosed with cancer in the five years after surgery was 6.2 percent, compared to 6.7 percent with a hip replacement made with other materials.
For women, the risk was 4 percent for a metal-on-metal stemmed hip replacement and 4.4 percent for a hip replacement made with other materials.
The researchers also found that the incidence of cancer is low after hip replacement and lower than that predicted for age- and sex-matched people in the general population.
The study was published online April 3 in the British Medical Journal.
It’s hoped that these findings will help doctors reassure patients that the “risk of cancer for hip replacement patients is relatively low,” the researchers wrote.
However, they added that long-term data on hip replacement patients needs to be collected over the next few decades as some cancers can take many years to develop.
Failure rates of stemmed metal on metal hip replacements
British researchers said there was “unequivocal evidence” that stemmed metal-on-metal hip replacements fail at much higher rates than other types of hip implants and should be banned.
The failure rate is particularly high for stemmed metal-on-metal hip implants with larger head sizes and those implanted in women. In these cases, failure rates are up to four times higher than other types of hip implants, according to the study in The Lancet.
Information provided by
The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases
It is worth noting that the cancer studies are based on patients with well-functioning MOM hips, not failing MOM hips. The difference is the level of cobalt and chromium in the blood.
Only one study to date has looked at failing MOM (metal on metal) hips (specifically ASRs). It was a small study (80 patients) but they found a higher than expected level of DNA changes within bladder cells and an increased incidence of pre-cancerous cell changes.
BHS advises to cease metal on metal hip replacements
The BHS has advised that MOM total hip replacements should no longer be performed. http://www.britishhipsociety.com/MoM%20Update.htm
The thinking is that, while they pose additional risk, as compared to a ceramic or metal-on-poly total hip, they do not offer any real advantage. On the other hand, MOM resurfacings pose a little less risk but do offer significant advantages.
The Medicines and Healthcare Regulatory Authority (MHRA) recently announced that patients who had undergone large head metal on metal hip implants are going to need monitoring, on an annual basis, for life.
Such implants, provided by DePuy Orthopaedics, a subsidiary of Johnson & Johnson, have a high failure rate and the rubbing together of the metal surfaces (cobalt and chromium) can cause metal flakes to break off and enter the body and blood stream causing tissue damage and other complications such as inflammation, destruction of muscle and bone, tumours and general pain and discomfort.
Further studies have shown that there maybe a link between the implants and the onset of various forms of cancer. The toxicity may be passed onto an unborn child in pregnant women.
The problems can arise in both those who had a full implant and those who underwent resurfacing work.
The MHRA have advised that there could be up to 50,000 high risk patients in the the country and that they should have regular blood tests to check for metal ions and MRI scans to see if they have raised metal levels. Previously the MHRA had suggested that there be a single five year post-oerative review however and in light of the issues concerning the deterioration of the fitting, this has been increased to an annual inspection and MRI scan and ultrasounds.
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