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Jonathan Cluett, M.D.

New Studies Question Metal-on-Metal Hip Replacements

By March 8, 2010

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New hip replacement implants are being developed and implanted into patients every year. With each development, hopes are that we will find better, longer-lasting joint replacements, that will have fewer potential problems. Unfortunately, not every developments works out as we might have hoped. In fact, many 'advancements' are found, sometimes years after they begin being implanted, to be inferior to more tried and true implants.

In the past decade, a specific type of implant, called metal-on-metal implants, have been implanted with increasing frequency. Metal-on-metal implants do not have a plastic spacer between the ball and socket, like standard hip replacements, and are thought to possibly last longer. Metal-on-metal hip replacements have been used in about 1/3 of hip replacements, and metal-on-metal is always used in hip resurfacing surgery.

New studies have shown that a small number of patients are having a reaction to the microscopic metallic debris that is created by the motion of these metal-on-metal implants. About 1-3% of patients may experience this complication where the metallic debris causes destruction of surrounding soft-tissue and bone. This is not an allergic reaction, but rather a response to the debris that causes damage to the surrounding tissues.

If you have a metal-on-metal hip replacement or hip resurfacing implant, be sure to check in regularly with your surgeon. Symptoms of this complication may include increasing pain, and your doctor should be able to see the bone destruction on an x-ray. The is no recommendation to remove the implants unless this complication should occur. Metal-on-metal implants are likely to continue to have a significant role in the future of hip replacement and hip resurfacing, and to date, there is no recommendation that these implants should not be used. Rather, caution and judgment must be weight to determine the best implant for each individual patient.

Related: Hip Replacement Implants | All About Hip Replacement | Metal-on-Metal Hips

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March 9, 2010 at 1:13 am
(1) dmather says:

Interesting “scare” article as it doesn’t seem to mention that plastic particles are also known to leave debris which also causes problems.

May 17, 2010 at 12:47 am
(2) ajwhite10 says:

It’s not a scare article at all. The debris from plastic bearings & the reaction it causes is completely different than these MOM bearings. Until you are in the operating room & see the incredible amount of damage done to the soft tissues from metal debri particulate reaction with these metal on metal hips, you can’t possibly understand.

August 11, 2010 at 6:30 pm
(3) Shirley Matthews says:

I’m can’t wait to get my MOM hip replaced with something different as the pain & disability It’s causing me is indescribable. Nights are awful as even with medication It’s almost impossible to get any rest. Seen on the 28th/07/10 by an orthopaedic consultant (after he had seen my blood and scan results) and now on an urgent list to have the surgery done.This will be my 3rd right hip replacement in 27 months !! (don’t ask why) I hope this 3rd time will be the beginning of a new and improved quality of life for me.

February 22, 2011 at 7:35 am
(4) Gill Headland says:

In September 2008 I underwent hip revision surgery in Llandough Hospital. the implant used was a Smith and Nephew R3 metal on metal hip implant. Over a period of two years my mobility decreased and decreased culminating in an extremely swollen painful leg. The swelling started in the groin spreading to the knee which became huge. So much so a doctor thought I had a bakers cyst and tried to draw fluid from the knee (there was none) he then gave me a cortisone injection into my knee, this was done in April 2010. The leg continued to swell and become more and more painful. I then went to the Heath hospital where they scanned my groin and saw a mass. I then went back to the Heath where they diagnosed a bad reaction to my metal on metal implant. I was then referred back to Llandough Hospital where I was seen by an Orthopaedic surgeon who said I needed blood tests to test the level of metal ions in my body and an MRI scan. It was then decided that I needed another revision to get the metal implant out of my body. This was carried out in Llandough Hospital on 16 September. The pain in my hip/groin has improved, but my upper thigh to my knee is still very swollen and painful.

The only advice to date I have been given is that they will carry out another MRI scan but they feel this will not show anything. I would very much appreciate your advice. I was even told it did not look too bad. I am not worried on a cosmetic level, I simply want to know why it is still so swollen. Does it mean there is still tissue damage and what can I do to help it.

I feel that this particular orthopaedic surgeon when he has finished with the mechanics of the operation that is the end. I do think however this should be looked at so more research can be carried out as to the long term effects of metal on metal implants damage to the body. I would also like to think no more people have to go through this by having metal on metal hip implants.

May 7, 2012 at 5:18 pm
(5) Suzie Q736 says:

Metal-on-metal hips have become a worldwide medical concern. By the time they were recalled in 2010, nearly 100,000 already had them; its raised questions about manufacturer and regulatory responsibility. But as always, we (the patients) end up suffering both physically and emotionally.

I am contemplating a revision surgery due to the constant pain I am in and my elevated chromium blood test numbers. The thought of another surgery and the recovery process is overwhelming, but looks like I don’t really have a choice.

March 9, 2013 at 8:32 pm
(6) CCD03092013 says:

In 2009, mother was diagnosed with Inflammatory Myopathy. She was healthy and vibrant but had a right hip replacement in March 2006 due to a fall, and a left knee replacement in July 2006 due to a previous injury the year before. After those two surgeries, she gradually became weaker. Her knee replacement hurt her since day one from post-op. I began doing research, and learned a great deal. YES, metal allergies to exist and if your knee or hip is not right, then rethink the revisions. My mother had Titanium revised in both implants, as pure as available. Her muscle tissue started re-growing, and now she is working her way back at 95% of being independent. It took 3 years to figure it out and by then the metal ions were destroying her muscle tissue. However, she is alive and doing great. SteelStandingdotcom is the web site where I wrote the medical breakthrough, with valid clinical/medical resources listed in the end notes. It’s an eye opening journey as we learned SO much, I wish each of you the best that have implants.

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