British Medical Jounal findings on metal on metal resurfacing

[kamoynsgi]

The BBC news has today featured grave conerns on metal on metal resurfacing as raised by the British Medical Council

The government's health regulator has advised that patients who have undergone large head metal-on-metal hip replacements should be monitored annually for life.  They say:-

'The new advice comes as a joint BBC Newsnight and British Medical Journal investigation reports that problems with such devices have been long known, but no action taken to block their use.
All-metal hips have a high failure rate and rubbing between the ball and cup can cause metal to break off, seeping into tissue and causing complications.
But despite the fact that the risks posed by these minute pieces of metal have been known and well documented for decades, patients have been kept in the dark'

This worries me as I am due to have a hip resurfacing procedure in 3 months time. Is this new research or does it re-state what has already been identiied and addressed.

[Pat Walter]

Please understand that they can't put all Metal on Metal THRs and hip resurfacing devices together and make a statement that "All metal hips have a high failure rate"

Read my summary of the National Registry for hip resurfacing and specifically the BHR which has a retention rate of 96% overall and much higher for certain categories like larger people and many of the top doctors series.
http://surfacehippy.info/hiptalk/index.php?topic=3374.0

Look at the real stats from the National Directories. http://www.surfacehippy.info/nationalregistries.php

Listen to McMinn's discussion about the negative press
http://www.surfacehippy.info/mcminnnegativepr.php

Read Mark Bloomfields article about the negative press  http://surfacehippy.info/hiptalk/index.php?topic=3456.0][url]http://surfacehippy.info/hiptalk/index.php?topic=3456.0[/url]

Read this article about the BHR http://surfacehippy.info/hiptalk/index.php?topic=3425.0

There are plenty of statistics showing how well the BHR has done since 1997.  Putting all devices together along with THRs is not a good way to look a metal on metal resurfacing.  The ASR was not a good device, but that does not mean the BHR is not a good device.

We have to start taking time to do some reading and research and not running scared every time a new negative press article is published.  There have been problems with a lot of MOM THRs and certain hip resurfacing devices - but not the BHR and several other devices.  The BHR is head and shoulders above all the others in retention rates and has the longest record of any hip resurfacing device.

I hope that helps.

Pat

[Jeremy76761]

I have viewed the BBC interview with Professor Sir Kent Woods, chief executive of the Medicines and Healthcare products Regulatory Agency.

Again the media demonstrates a bias against MOM devices and we see a more rational view coming from the regulatory agency. The interviewer recommends controlled studies prior to MOM approval. Controlled research studies that would evaluate metal ion affect decisively would require observing effects over the human lifespan. If longitudinal studies were required for every device, we'd still be waiting for results from the first devices implanted in the 1960s, and fusing hips instead. We need to consider the evidence that was weighed when MOM devices were approved, and the results since, to assess whether approval was (and is) reasonable. The media interview weighs a lot of factors against one another but leaves others out and neglects the quantification that makes any analysis meaningful.

What is interesting is the failure of regulatory agencies and general medical establishment to protect against the DePuy products in particular.   

[John C]

When I read this report from the British Medical Council, there was one critical paragraph buried in the report that is easily overlooked. I believe it stated that smaller head MOM devices, and hip resurfacing devices such as the BHR, were exempt from the advisement for lifelong blood tests. I wish that I had saved the full report, but if you want to look it up, be sure to read down to this paragraph that exempts certain devices from the advisement.

[Dannywayoflife]

Sounds like yet more scare mongering to me! If MOM was so bad and had such a high failure rate then how come pretty much all the ring and mcfarra hips that were properly engineered (was hard in those days to ensure the qc) lasted 20+years and some out to 40+ years? I would wager that these studies are done by surgeons who are not capable of positioning the devices right and therefore want to cover there ass's! They then conveniently blame MOM and say we don't have these problems with metal on plastic but that's because plastic can be put in wrong and still work (for some time at least!) why don't they pay more attention to the figures of surgeons like Mcminn, Treacy, O'Hara,Latham etc? I can 100% guarantee that there figures will be totally and utterly different!! 

[SeanD]

I'm having a BMHR shortly. I'm becoming concerned that the NHS may start refusing this treatment based on this information, despite the fact that all the data available clearly shows that these devices have a high success rate.

I've got no concerns about the Birmingham devices based on the info I've gathered, I'm more worried that the NHS might be unwilling provide such treatment.

[Dannywayoflife]

I doubt that it will come to that. Who is going to do your BMHR?

[SeanD]

Doug Dunlop or Jeremy Latham.

[Dannywayoflife]

Jeramy Latham is an excellent surgeon. There are several of his patients on here.

[kamoynsgi]

Thank you for helping me get a better perspective on the bad press.  The wealth of knowledge on the site and the feedback from other members really helps me look forward to my op and maintain positivity.