- Mr. McMinn Responds to MHRA Guidelines July 2017
- Updated Guidelines To Monitor Metal on Metal Devices by UK’s MHRA 2017
- Women More Sensitized than Men to Metal in Hip Replacement Medical Study
- Metal in Total Hip Arthroplasty: Wear Particles, Biology, and Diagnosis
- Two4One 2 Years after my BHR Revisions I’m HEALED!!
- Vicky Marlow Interviews Pat Campbell about Metal Ions
- Normal Levels of Cobalt and Chromium after Hip Resurfacing
- New Blood Test Finds Allergies Before Surgery
- McMinn About Metal on Metal Implants
- Metal Ions Questions and Answers by Mr. McMinn of UK
- Peter Kay Response to Metal Ion Level Test
- High Metal Ions, Pseudotumors, Metalosis & ALVAL
- Allergy to Joint Replacements Koen De Smet, Pat Campbell
- Metal Ion Study with Triathlete
- Metal Allergy Discussion by Dr. Jacobs 2012
- Cobalt And Chromium Ion Levels Patients with Hip Resurfacing Prosthesis
- Metal ion levels in the blood of patients after hip resurfacing
- Researchers set
Response to Telegraph Article – News Feed Monday 3rd July 2017
In response to the recent Telegraph article, Mr McMinn would like to reassure all of his patients that nothing has changed in the outcomes of our hip resurfacing and total hip replacement patients. Our results do not show anything different, but the MHRA guidelines have changed, probably because of some reports of small diameter metal-on-metal total hip replacements. We have not had an increase in our failure rates due to metal reactions. A small percentage of hips had to be revised to non-metal-on-metal total hip replacements, but the percentage of patients needing revision for all wear-related problems and metal-reactions is less than 1% in men, and less than 3% in women at 19 years.
We have investigated the earliest series of our BHRs, with extensive assessments including CT scanning at post 10-year reviews, … Read the rest
The Medicines and Healthcare products Regulatory Agency (MHRA) UK has called for longer-term monitoring of all patients fitted with metal-on-metal hip implants, as a precautionary measure, in an update to its original guidance issued in 2012.
“MHRA, in colsultation with its independent Metal-on-Metal Expert Advisory Group (MoM EAG), has continued to monitor the performance of MoM hip joint articulations for the occurrence of soft tissue reaction associated with these devices. However, some patients will develop progressive soft tissue reactions to the wear debris associated with MoM articulations.”
Advice varies according to device, age and sex of patients. The BHR is device with a 10A ODEP rating. Those patients are recommended to have follow-ups and blood tests: First year, once at seven years and three yearly thereafter.
Recent studies indicate that females demonstrate an increased risk of experiencing adverse local tissue reactions, aseptic loosening, and revision after primary metal-on-metal hip resurfacing arthroplasty compared with males; the underlying biological mechanisms responsible for sex discrepancies in implant failure remain unclear. In addition to anatomical and biomechanical sex differences, there may be inherent immunological disparities that predispose females to more aggressive adaptive immune reactivity to implant debris, i.e., metal sensitivity…
…The findings support the possibility that the higher rate of complications after TJA in women may have an “adaptive immunological basis.” But it is still unclear whether the sex-related difference in immune sensitization is related to intrinsic biologic factors, such as hormones, or to environmental factors, such as exposure to metals in jewelry or cosmetics.… Read the rest
September 15, 2016 – First, I want to correct that I had my last ceramic and titanium bilateral hip revisions (to a failed bilateral Birmingham Hip Resurfacing) completed in November 2014 – not Nov 2105.
Secondly, after an almost 2 year recovery, I can most happily report that both hips AND knees do not hurt!! At most, my hips get stiff after prolonged use and I can’t squat as easily. Those of you who have followed my journey KNOW how amazing this is.
I ended up doing a round of PT for my knees, which did not work. Then, I researched and found the amazing DIY “Beating Patellar Tendonits” by a Physical Therapist and used it to do an additional 2 months of knee work with a Personal Trainer. My knees are great now! https://www.amazon.com/Beating-Patellar-Tendonitis-Treatment-Pain-free/dp/1491049731/ref=sr_1_1?s=books&ie=UTF8&qid=1473896232&sr=1-1&keywords=beating+patellar+tendonitis
Recently though, I strained all my chest muscles from overdoing … Read the rest
Studies were searched for in the Medline database, Embase, and the Cochrane Database of Systematic Reviews. Highest mean or median ion concentrations of Cr and Co after a minimum of 1 year of follow-up were extracted and grouped according to sample- and articulation type, and average values were calculated…
…43 studies were included and 16 different MoM implants were identified. For the different types of bearings, average ion concentrations and range were calculated from the mean or median ion concentration. The average Cr concentration ranged between 0.5 and 2.5 μg/L in blood and between 0.8 and 5.1 μg/L in serum. For Co, the range was 0.7–3.4 μg/L in blood and 0.3–7.5 μg/L in serum…
The MHRA (medicines and healthcare products regulatory agency) the statutory body that regulates resurfacing devices in the UK advocates the figure of 119 nmol/L cobalt (or 7 parts per billion, … Read the rest
Derek McMinn addresses the recent Concerns about Hip Resurfacing and Metal on Metal (MoM) implants Interview by Vicky Marlow
Original Link: http://vimeo.com/12418781
Internationally renowned hip and knee surgeon and designer and pioneer of the Birmingham Hip Resurfacing, Derek McMinn addresses concerns about Hip Resurfacing and Metal on Metal (MoM) implants.
Derek McMinn has done over 6000 total hip surgeries and over 3,500 MoM Hip Resurfacings. His 10 year survivorship for the BHR (Birmingham Hip Resurfacing)in a series of 3095 performed up until December 2009 is 97% from all patients. His first metal/metal resurfacing prototype was implanted in 1991, and the current design, the first BHR was implanted in July 1997 and has not changed in any way since then.
In Part 1, Mr. McMinn discusses the history of the BHR device and talks about the reasons … Read the rest
Metal Ions Questions & Answers Original information from McMinn Center Website below:
Earlier in 2011, the McMinn Centre team travelled to a meeting in Arizona and answered several questions about Metal-on-Metal (MoM) implants and issues to do with metal ions. The questions were posted by BHR users. For the benefit of the entire Hip Resurfacing community, the answers to those questions are provided below.
Patients concerned about the recent, negative ASR press coverage may also be interested to read the information below.
Thank you to Vicky Marlow for providing the questions for our team.
1. Is there a specific test that is more accurate for metal level testing and what should a patient ask for when they go to their doctor to order the test?
We use whole blood specimens drawn into lithium-heparin containing tubes with non-contamination precautions, and analysed with HRICPMS (high resolution inductively coupled plasma mass spectrometry) … Read the rest
|Peter Kay Response to Metal Ion Level Test for MOM in UK after FDA update 1/2013I think overall, from the U.K. perspective, metal-on-metal has been a real problem. (For) most surgeons in the United Kingdom, our usage of metal-on-metal hip replacements has dwindled to almost nothing because we cannot really find any advantage. The patients do not do any better in terms of function. There is some evidence the patient’s reported pain levels are higher anyway and the revision rate is higher, so it is not adding much value.In terms of metal-on-metal, we (Medicines and Healthcare products Regulatory Agency) have gone a little bit further than the FDA because we also recommend having a metal ion level test. It is very hard to find a metal ion level where you can say whether patients are likely to run into problems, but one of the reasons we chose to|
Article by Patricia Walter and Hip Resurfacing Surgeons
Patients and prospective patients are always concerned about the complications that could occur after a hip resurfacing surgery. The typical problems include femur neck fractures, dislocations, loose acetabular cups, improperly positioned acetabular cups, high metal ions, infections, pseudotumors, ALVAL and metalosis.
There has been a lot of discussion among patients on discussion groups about the high metal ion issue and pseudotumors. I am not a doctor or medically trained. I am a Patient Advocate, Hip Resurfacing Patient and Mechanical Engineer. I had the opportunity to attend the Second Annual U.S. Comprehensive Course on Total Hip Resurfacing Arthroplasty October 24–25, 2008 Los Angeles, CA. I listened to discussions about the metal ion issues and pseudotumors. I am going to explain what I learned in simple, non-medical terms since that is all I can do.
As an observer, I learned that the high metal … Read the rest