The Medicines and Healthcare Products Regulatory Agency is calling for all metal-on-metal (MoM) hip replacement recipients to schedule follow-up appointments to monitor and detect adverse soft tissue reactions. The recommendation, published by the agency on June 29, warns people that progressive soft tissue necrosis (death of living tissue) may occur in both asymptomatic and symptomatic metal-on-metal hip replacement patients.
The alert states: “The majority of patients with MoM hip replacements currently have well-functioning hips. However, some patients will develop progressive soft tissue reactions to the wear debris associated with MoM articulations.” The follow-up visits may include MRI (magnetic resonance imaging) or ultrasound scan, and isolated fluid collection, notes the agency.
Vital Role of Physiotherapy
Physiotherapists could be vital to the early detection of problems with MoM implants, said Katie Monnington, a specialist hip physiotherapist at the Royal National Orthpaedic Hospital NHS Trust in Stanmore, London.
Mrs. Monnington is a member of the Association of Trauma and Orthopaedic Chartered Physiotherapists (ATOCP). She told Frontline: “MoM hips can in the first instance, silently damage and impair the muscular stability system around the hip joint. Physiotherapists play an important role in detecting these early muscle problems, which can create challenges for rehabilitation and should be investigated with an MRI scan. And if an MoM hip is revised, post-operative physiotherapy is crucial to target the deep muscular stability system and to ensure that best muscle patterning and patient function can be achieved.”
The national law firm Parker Waichman LLP has extensive experience in medical device litigation, including metal-on-metal hip implant lawsuits. Attorneys at the firm are available to answer any questions for those individuals seeking legal information for a potential lawsuit.
Alister Hart, a consultant orthopaedic surgeon and director of research at the hospital, supports a multidisciplinary approach and spoke at an ATOCP meeting earlier this year. Ongoing work at the London Implant Retrieval Centre aims to improve outcomes for hip implant patients, Professor Hart indicated to Frontline.
“We are establishing a better understanding of painful hip replacements and analyzing prostheses that are removed due to complications from MoM hips,” she said. “This research, together with close multidisciplinary working, will facilitate how we best manage these patients.”
Better Outcomes for Hip Replacement Surgery
According to a new study carried out by researchers at the University of Oxford and funded by Arthritis Research UK and the Orthopaedics Trust, data shows that patients who need metal-on-metal hip revision surgery are experiencing better outcomes in the United Kingdom (UK) than they did five years ago.
The study reviewed data from the National Joint Registry covering 2,535 metal-on-metal hip replacement patients who needed revision surgery after suffering abnormal reactions to metal. It found the outcomes following revision for MoM patients are now comparable to the outcomes in patients with other types of hip replacement surgery. Researchers behind the study remark the improvement may be due to an increase in experience among surgeons, reports the Chartered Society of Physiotherapy.
Metallosis Issues
Metallosis (metal poisoning) is a serious condition when toxic levels of metal build up and over time components of the metal-on-metal hip rub together during everyday movements. Tiny metallic debris is created that may enter the patient’s bloodstream and severely damage muscle and tissue.
In addition to metallic debris in the bloodstream, recipients of the metal-on-metal hips have reported numerous complications that include loosening of the joint, hip dislocation, severe pain, difficulty walking, and cysts around the joints.
Symptoms may include skin rash, heart disease, hearing or visual impairment, kidney failure, and if left untreated, depression, thyroid dysfunction leading to possible weight gain, temperature sensitivity, fatigue, or neck discomfort. Thousands of patients filed lawsuits over such injuries and complications that continue to mount in numbers.
Metal-on-metal was believed to extend the life of customary hip implants that used traditional materials such as ceramic. It was thought that this would expand the market to a growing, younger population base that would be more active and seeking more resilient and sturdier implants than that of a previous generation.
As technology progresses and experience is gained, the hope is for more successful, pain-free hip replacement procedures for people who will receive ever-improving hip replacements in the future.
.svg){kind=small}
.avif)
.avif)