Metal on Metal warning (old but ongoing news)
- Thread starter Dingbat7
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cotton1958
supremo
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Metal-on-metal story has also been on the NPR, Health page too. (National Public Radio)
it was in Spain too and my friend got anxious because, as he said it, he has metal hip in. I pointed out that all hips are metal, it depends what top and cup liner they have and then reminded him that he has a metal ball in a plastic cup! 
Bumpa
graduate
Some good news on this subject:
No greater cancer risk for patients with metal-on-metal hip implants, study says. Patients with metal-on-metal implants stand no more chance of developing cancer 7 years after hip replacement than the general population, according to findings of a study commissioned by the National Joint Registry of England and Wales and Hospital Episode Statistics.
For their study, investigators from the Universities of Bristol and Exeter analyzed the cancer rates in patients with metal-on-metal (MoM) hip implants and compared them with the cancer rates of patients with other bearing surfaces and the general population, according to a British Medical Journal press release. Using data from the national joint registry, identified 40,576 patients with MoM bearing surfaces, 21,264 patients stemmed MoM prostheses and 19,312 patients who underwent resurfacings.
The researchers collected data on patient age and gender, and assessed general health at the time of surgery using diagnostic codes recorded at the time of injury, American Society of Anesthesiologists grade and admissions to the hospital in the previous 5 years. The authors noted in their study that comparison with the general population was not straightforward because hip replacement patients “tend to be healthier than others of the same gender and age group.”
According to the release, the investigators discovered a 60-year-old man in moderate health with a MoM stemmed hip replacement would have a 6.2% chance of being diagnosed with cancer 5 years postoperatively compared to a 6.7% chance if other bearing surfaces were used. Women aged 60 years with MoM stemmed hip replacements showed a 4% chance of developing cancer during the same time period compared to a 4.4% chance if they had other bearing surfaces. The investigators also found that cancer rates were lower than predicted for both hip replacement patients and the general population.
The study authors hope clinicians can use the information to inform patients that cancer risks are low for MoM hips. Further studies are ongoing to acquire long-term data, the release noted, as cancer may develop after years or decades.
References:
Smith AJ, Dieppe P, Porter M, Blom AW. Risk of cancer in first seven years after metal-on-metal hip replacement compared with other bearings and general population: Linkage study between the National Joint Registry of England and Wales and hospital episode statistics. BMJ 2012; 344 doi:10.1136/bmj.e2383. (Published 3 April 2012.)
No greater cancer risk for patients with metal-on-metal hip implants, study says. Patients with metal-on-metal implants stand no more chance of developing cancer 7 years after hip replacement than the general population, according to findings of a study commissioned by the National Joint Registry of England and Wales and Hospital Episode Statistics.
For their study, investigators from the Universities of Bristol and Exeter analyzed the cancer rates in patients with metal-on-metal (MoM) hip implants and compared them with the cancer rates of patients with other bearing surfaces and the general population, according to a British Medical Journal press release. Using data from the national joint registry, identified 40,576 patients with MoM bearing surfaces, 21,264 patients stemmed MoM prostheses and 19,312 patients who underwent resurfacings.
The researchers collected data on patient age and gender, and assessed general health at the time of surgery using diagnostic codes recorded at the time of injury, American Society of Anesthesiologists grade and admissions to the hospital in the previous 5 years. The authors noted in their study that comparison with the general population was not straightforward because hip replacement patients “tend to be healthier than others of the same gender and age group.”
According to the release, the investigators discovered a 60-year-old man in moderate health with a MoM stemmed hip replacement would have a 6.2% chance of being diagnosed with cancer 5 years postoperatively compared to a 6.7% chance if other bearing surfaces were used. Women aged 60 years with MoM stemmed hip replacements showed a 4% chance of developing cancer during the same time period compared to a 4.4% chance if they had other bearing surfaces. The investigators also found that cancer rates were lower than predicted for both hip replacement patients and the general population.
The study authors hope clinicians can use the information to inform patients that cancer risks are low for MoM hips. Further studies are ongoing to acquire long-term data, the release noted, as cancer may develop after years or decades.
References:
Smith AJ, Dieppe P, Porter M, Blom AW. Risk of cancer in first seven years after metal-on-metal hip replacement compared with other bearings and general population: Linkage study between the National Joint Registry of England and Wales and hospital episode statistics. BMJ 2012; 344 doi:10.1136/bmj.e2383. (Published 3 April 2012.)
OP
OP
Dingbat7
senior
And I am sure that there is another study somewhere that says it does , having worked in the public sector stats can be manipulated and shown which ever way it suits , results of research no different, it just depends how worried one is as to whether you take any action, in this case insist on a different implant or have it replaced etc.
If we believed the results of every scientific study the human race would die out as none of us would eat or drink anything
And anyway you never know if you are that 1% or the 1 in a million it does effect.
If we believed the results of every scientific study the human race would die out as none of us would eat or drink anything
And anyway you never know if you are that 1% or the 1 in a million it does effect.
You know what? I'd take a supposition from the JR(UK) any time over many other studies! At least we know for sure
a) who these guys are
b) that they are trawling this from information provided to a legitimate and broad spectrum data base, not just a study from their amongst their own patients!
And at the rate that hip and knee replacements are being done these days, I'd think it pretty inevitable that a goodly proportion would get cancer of some kind at some point and would have got it even if that hadn't had a replacement!
a) who these guys are
b) that they are trawling this from information provided to a legitimate and broad spectrum data base, not just a study from their amongst their own patients!
And at the rate that hip and knee replacements are being done these days, I'd think it pretty inevitable that a goodly proportion would get cancer of some kind at some point and would have got it even if that hadn't had a replacement!
OP
OP
Dingbat7
senior
But you have to remember most of us on here are lay people and the stats research and other stuff mean something to you ex professionals, but go straight over our heads.....keep it simple ( like me) I say 
OP
OP
Dingbat7
senior
That was one of my comments to try and lighten the thread up , I asked why no one had tested the MOM's on the PG chimps, see post #20 :th_heehee:
Bumpa
graduate
To be published in the BMJ tomorrow:
Hope it doesn't offend one of our sponsors!
An unpublished trial of a metal-on-metal total hip replacement, funded by the US medical device company Stryker, was stopped early more than a year before the UK regulator told surgeons not to use the implant, the BMJ has learnt.
Earlier this month the Medicines and Healthcare Products Regulatory Agency (MHRA) told surgeons to stop using the MITCH TRH cup/heads, made by Finsbury Orthopaedics (now Depuy), in combination with Accolade femoral stems made by Stryker Orthopaedics.
The instruction came after the National Joint Registry for England and Wales showed a higher than acceptable revision rate of 10.7% at four years among 271 patients.
However, a Stryker funded trial conducted at the Freeman Hospital in Newcastle upon Tyne was stopped more than a year earlier after …(to get the full article would cost me and we Geordies are tight with money)
Hope it doesn't offend one of our sponsors!
An unpublished trial of a metal-on-metal total hip replacement, funded by the US medical device company Stryker, was stopped early more than a year before the UK regulator told surgeons not to use the implant, the BMJ has learnt.
Earlier this month the Medicines and Healthcare Products Regulatory Agency (MHRA) told surgeons to stop using the MITCH TRH cup/heads, made by Finsbury Orthopaedics (now Depuy), in combination with Accolade femoral stems made by Stryker Orthopaedics.
The instruction came after the National Joint Registry for England and Wales showed a higher than acceptable revision rate of 10.7% at four years among 271 patients.
However, a Stryker funded trial conducted at the Freeman Hospital in Newcastle upon Tyne was stopped more than a year earlier after …(to get the full article would cost me and we Geordies are tight with money)
Dear Josephine- thanks for your updates and research on the M.O.M. situation. I have a metal resurfaced hip of 4 years, I was one of the last to have it done in our area.
Recently I have had a few odd , new but mild symptoms around this hip. Thankfully my surgeon was only too happy to see me and discuss things and give me a blood test etc. I feel reasured and lucky to have a good orthapoedic hospital where I live. It does seem the press has really whipped things up- we need to be aware and watch for symptoms, but how unhelpful is 'crying wolf' ( over cancer scares etc)- it may well fudge the real issues and water down a genuine response.
Thanks for all you are doing,
Rosyros
Recently I have had a few odd , new but mild symptoms around this hip. Thankfully my surgeon was only too happy to see me and discuss things and give me a blood test etc. I feel reasured and lucky to have a good orthapoedic hospital where I live. It does seem the press has really whipped things up- we need to be aware and watch for symptoms, but how unhelpful is 'crying wolf' ( over cancer scares etc)- it may well fudge the real issues and water down a genuine response.
Thanks for all you are doing,
Rosyros
I have a metal on metal hip implant and am always concerned not only about the failure but about the cobalt poisoning risk and the harm that it is doing to my body. According to this article (admin edit - article no longer available) it at least seems that the FDA is going to watch more closely – not that I have much faith.
Terrible situation for a lot of people who wanted quality of life back. If it is not one thing, it certainly is another. Off I go to get a blood test.
Terrible situation for a lot of people who wanted quality of life back. If it is not one thing, it certainly is another. Off I go to get a blood test.
Patrisha, the article you quoted, dated yesterday, is already being discussed by the British Orthopaedic Association as per this report of a meeting I attended last December! Metal-on-Metal Hip Replacements: Solving The Uncertainties
cz, that article, dated April 3rd, was prompted by a report in the Lancet which I reported on here in this thread on March 13th!
If you want up-to-date information, come to BoneSmart!
cz, that article, dated April 3rd, was prompted by a report in the Lancet which I reported on here in this thread on March 13th!
If you want up-to-date information, come to BoneSmart!
Bumpa
graduate
Right, on this question of metal-on-metal this article appears to be a good summary of the situation at this time especially the last sentence (this will ensure you read the full article!):
Global time-out may calm maelstrom of metal-on-metal THR
Orthopaedics Today Europe, Issue 2
Like a giant storm passing over the countryside, blowing down trees and destroying houses, the metal-on-metal hip bearing situation has had a damaging effect, toppling many clinicians’ decisions to use that bearing coupling and possibly marring the landscape of total hip replacement (THR) forever.
In a recent article in Lancet, British experts recommended orthopaedists stop using large-head (LH) metal-on-metal (MoM) hip prostheses because National Joint Registry of England and Wales data showed they have higher revision rates than ones with ceramic or polyethylene bearings. The authors also suggest these higher early failure rates may extend beyond the recalled ASR (DePuy Orthopaedics) resurfacing prosthesis to all LH MoM bearings.
While not the final solution, a moratorium on MoM bearings makes sense in many respects, particularly from the patient’s perspective. So until all the issues are clarified, we should support a global time-out for LH MoM THR.
The U.K. Medicines and Healthcare Products Regulatory Agency recently issued new guidelines stating patients with MoM hip replacements with head diameters of 36 mm or more should be monitored annually for the life of the THR. To manage patients with MoM hip bearings, international guidelines are needed regarding frequency of performing examinations, blood ion level tests, and ultrasound and MRI scans in symptomatic patients, and when revision is advised.
We must educate patients and the media on the effectiveness of LH MoM bearings in properly selected patients, that very few patients with those bearings will ever require a reoperation for any of the publicized problems, and the same negative effects are not reported with other types of THR bearings. Just as critical is communicating to all patients that no THR lasts forever and each device has its own risk of revision.
I suggest international health authorities partner with the European Federation of National Associations of Orthopaedics and Traumatology, the American Academy of Orthopaedic Surgeons and other groups to develop device regulations mandating that certain steps and clinical trials be completed before wide scale adoption of THR implants.
Therefore, I recommend THR implants be classified as follows:
What implant would you choose if you needed THR today? I know what I would do — find a highly experienced surgeon who can verify that the prosthesis he or she recommends for me is a “proven implant.”
Reference:
Smith AJ, Dieppe P, Vernon K, et al. Failure rates of stemmed metal-on-metal hip replacements: Analysis of data from the National Joint Registry of England and Wales. Lancet. 2012 Mar 12.
Global time-out may calm maelstrom of metal-on-metal THR
Orthopaedics Today Europe, Issue 2
Like a giant storm passing over the countryside, blowing down trees and destroying houses, the metal-on-metal hip bearing situation has had a damaging effect, toppling many clinicians’ decisions to use that bearing coupling and possibly marring the landscape of total hip replacement (THR) forever.
In a recent article in Lancet, British experts recommended orthopaedists stop using large-head (LH) metal-on-metal (MoM) hip prostheses because National Joint Registry of England and Wales data showed they have higher revision rates than ones with ceramic or polyethylene bearings. The authors also suggest these higher early failure rates may extend beyond the recalled ASR (DePuy Orthopaedics) resurfacing prosthesis to all LH MoM bearings.
While not the final solution, a moratorium on MoM bearings makes sense in many respects, particularly from the patient’s perspective. So until all the issues are clarified, we should support a global time-out for LH MoM THR.
The U.K. Medicines and Healthcare Products Regulatory Agency recently issued new guidelines stating patients with MoM hip replacements with head diameters of 36 mm or more should be monitored annually for the life of the THR. To manage patients with MoM hip bearings, international guidelines are needed regarding frequency of performing examinations, blood ion level tests, and ultrasound and MRI scans in symptomatic patients, and when revision is advised.
We must educate patients and the media on the effectiveness of LH MoM bearings in properly selected patients, that very few patients with those bearings will ever require a reoperation for any of the publicized problems, and the same negative effects are not reported with other types of THR bearings. Just as critical is communicating to all patients that no THR lasts forever and each device has its own risk of revision.
I suggest international health authorities partner with the European Federation of National Associations of Orthopaedics and Traumatology, the American Academy of Orthopaedic Surgeons and other groups to develop device regulations mandating that certain steps and clinical trials be completed before wide scale adoption of THR implants.
Therefore, I recommend THR implants be classified as follows:
- Proven implants, ones with high 10-year survival rates in recognized national registers, may be widely released, marketed and used by trained joint replacement surgeons;
- Promising implants,, those with good register results not yet at the proven implant level, may have limited, but closely observed clinical use; and
- Experimental implants, which are all other THR devices, must be used on an extremely limited basis under strict observation by the authorities that originally approved them for study and use.
What implant would you choose if you needed THR today? I know what I would do — find a highly experienced surgeon who can verify that the prosthesis he or she recommends for me is a “proven implant.”
Reference:
Smith AJ, Dieppe P, Vernon K, et al. Failure rates of stemmed metal-on-metal hip replacements: Analysis of data from the National Joint Registry of England and Wales. Lancet. 2012 Mar 12.
Yeah, it did!
jancat
graduate
Here is the NPR story I heard on the radio as I was driving to the train station for pre-op testing for my TKA: http://www.npr.org/blogs/health/2012/03/19/148769073/prone-to-failure-some-all-metal-hip-implants-need-to-be-removed-early
Until I heard this story I had no idea that was going on.
Until I heard this story I had no idea that was going on.
OP
OP
Dingbat7
senior
I wish I hadn't started this thread now , I would imagine a lot of worried people out there, sometimes ignorance (until syptoms begin) better than worring about what could happen.
Breast Implants, Hip replacements, what next ???
Breast Implants, Hip replacements, what next ???
