Every patient fitted with a metal-on-metal hip joint is being advised by the Medical and Healthcare products Regulatory Agency (MHRA) to undergo X-ray and blood tests.
The watchdog has issued the warning after the hip replacement products have been found to be more toxic than first thought. This means that 56,000 patients need to have medical tests to see whether they are suffering from muscle or bone damage and metal toxicity.
MHRA, in consultation with the Metal-on-Metal Expert Advisory Group (MoM EAG), has monitored the performance of metal-on-metal hip joint replacements for the occurrence of soft tissue reaction associated with these devices. The majority of patients with metal-on-metal hip replacements currently have well-functioning hips. However, some patients will develop progressive soft tissue reactions to the wear debris associated with metal-on-metal joints.
A statement from MHRA also says that its clinical orthopaedic experts have observed that soft tissue necrosis (death of living tissue in a localised area) may occur in patients whether they are showing symptoms or not, and believe early detection should give a better outcome should a replacement hip become necessary.
The decision to advise patients to have checks could result in thousands of people undergoing further surgery to replace the implants. Surgeons are particularly concerned about the consequences for female patients and have advised that they go for annual checks even if they have no concerns or adverse symptoms.
Metal-on-metal hip replacements
Metal-on-metal implants have largely been phased out since their introduction in the 1990s. At the time they were promoted as an option for active younger patients because they give better mobility than metal ball and plastic socket hip implants.
Andrew Taylor, Clinical Negligence specialist and a partner at Birchall Blackburn Law, says: “If you have any concerns about your hip replacement then you should book an appointment with your GP or consultant surgeon to discuss.
“The MHRA has stressed that not every patient with metal-on-metal hip implants will need to have them removed and replaced. Similarly, not everyone will suffer adverse symptoms or injury but growing evidence suggests that muscle damage caused by the implants can become progressively worse – even irreversible – without patients suffering symptoms.
“If the worst does happen then a patient should seek advice about their rights as quickly as they feel able to. If a compensation claim is possible against the makers of the metal-on-metal hips then the outcome could make all the difference to the speed and quality of the replacement of the hip joint and recovery.”