Call for wider ban on metal hips — Study

2012-03-26 00:00

NEW research confirmed that all-metal artificial hips fail more often than other types, fuelling concerns about the devices and prompting a call from researchers last week for a ban.

The analysis in The Lancet medical journal came two weeks after Britain’s medical regulator said nearly 50 000 Britons with metal-on-metal hips needed annual check-ups to monitor for problems, including exposure to toxic metals.

The finding will likely fuel criticism about the regulation of medical devices in the wake of a scandal over French-made breast implants and past problems with other implantable devices.

Metal-on-metal hips were developed to be more durable than traditional implants, which combine a ceramic or metal ball with a plastic socket.

But recent experience suggests that they may actually do worse, prompting the recall of one device made by Johnson & Johnson that critics argue should never have been allowed on the market.

Results from the most comprehensive study to date show that there is a 6,2% chance patients with all-metal hips will need a replacement within five years.

The team from the University of Bristol analysed data from the National Joint Registry of England and Wales covering more than 400 000 hips replacements, including 31 171 all-metal ones, that were undertaken between 2003 and 2011.

The results, they said, were unequivocal: “Metal-on-metal stemmed articulations give poor implant survival compared with other options and should not be implanted.”

In recent years, the use of metal-on-metal implants has declined in Britain, but they are still used extensively around the world, including in the United States.

Art Sedrakyan of Cornell University said the problem highlighted weaknesses in the regulatory systems on both sides of the Atlantic due to “outdated and low-threshold regulatory pathways”.

He called for better studies before implants reach the market.

“We are left with more than 500 000 patients with metal-on-metal prostheses in the United States and more than 40 000 in the United Kingdom who are at risk of device failure, which will inevitably result in the burden of further surgical treatment,” he said.

Ashley Blom of the University of Bristol said that total hip replacement surgery remained a very successful operation for the vast majority of people but regulators should learn lessons as they seek to balance safety against innovation. — Reuters.

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