The McMinn Centre Published on Dec 13, 2018
Mr Derek McMinn interviews Mrs Maureen Berry, a patient with a 46 year old Metal on Metal Total Hip Replacement and 22 year old Birmingham Hip Resurfacing. They talk about her experiences and how MoM hips can have highly successful outcomes.… Read the rest
Read Original Article at McMinn Center
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 … Read the rest
Original MEDICAL DEVICE ALERT by UK MHRA 2017 Available Here
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 … Read the rest
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 … Read the rest
Very Interesting article explaining metal on metal wear in total hip replacement which is similar to hip resurfacing mom devices.
Read Two4One’s Full Story Here
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 … Read the rest
Vicky Marlow, Patient Advocate who has sadly passed on, interviews Pat Campbell about Metal Ions and Pseudotumors in 2009.
Dr. Pat Campbell from Vicky Marlow – Patient Advocate on Vimeo.… 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…
Additional Information
The MHRA (medicines and healthcare … 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.
Metal Ions Questions & Answers Original information from McMinn Center Website below:
http://www.mcminncentre.co.uk/metal-ions-questions-answers.html
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 … Read the rest
| Peter Kay Response to Metal Ion Level Test for MOM in UK after FDA update 1/2013 I 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 |
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 … Read the rest
Occasional reports of joint replacement implant failure because of an apparent allergy to one of the metals in the device have appeared in the orthopedic literature ever since metal implants were used. (1-3) It is now recognized that a small number of patients will suffer from a form of allergy or hypersensitivity to constituents of the metal-on-metal bearings even in the absence of high wear or a known metal sensitivity (4-6). The histological features of the reaction characterizing the joint tissues from these hypersensitive patients are different from the classical text-book form of Type 4 DTH. (7) For this reason, the term ALVAL (aseptic lymphocytic vasculitis associated lesions) has been coined to describe the histological features associated with an allergy-like reaction in the joint tissues. … Read the rest
| Metal ion levels in a triathlete with a metal-on-metal resurfacing arthroplasty of the hipR. De Haan, MD, Orthopaedic Resident1; P. Campbell, PhD, Research Scientist, Associate Professor2; S. Reid, MD, PhD, Sports Medicine Physician3; A. K. Skipor, MS, Research Scientist4; and K. De Smet, MD, Orthopaedic Surgeon1 1 ANCA Medical Center, Krijgslaan 181, 9000 Gent, Belgium. 2 J Vernon Luck Snr MD, Orthopaedic Research Center, Orthopaedic Hospital, 2400 S., Flower Street, UCLA, Los Angeles 90007, California, USA. 3 St. Helen’s Private Hospital, 186, Macquarie Street, Hobart, Tasmania 7000, Australia. 4 Department of Orthopaedic Surgery, Rush Presbyterian St Luke’s, Medical Center, Room 756, Cohn Research Building, 1735 West Harrison Street, Chicago, Illinois 60612-3833, USA. A prospective study |
Read more here: Although metal allergy with total joint replacement exists, the prevalence of this condition is unknown, according to Joshua J. Jacobs, MD. “Metal allergy [with] orthopedic implants has been well documented in isolated cases,” Jacobs said during his presentation at the American Academy of Orthopaedic Surgeons 2012 Annual Meeting/Orthopaedics Research Society symposium. “The true prevalence is unknown. Clinically significant symptomatologies seem to be rare in total knee replacements and metal-on-polyethylene total hip replacements, but much more common in metal- on-metal total hips. Based on case reports and device literature, Jacobs said that metal allergy exists and has been seen as a temporal association. It can have different presentations and many involve a rash. In some examples, patients suffer skin reactions after implantation of |
Cobalt And Chromium Ion Levels In
Patients With a Metal On Metal Hip Resurfacing
Prosthesis
AAOS San Diego Convention Center, Sails Pavilion
2007
Adult Reconstruction Hip
Michael Dunbar, MD, PhD Halifax NS Canada (a)
G Yves Laflamme, MD ,FRCS Montreal QC Canada (a)
Paul E Beaule, MD Ottawa ON Canada (a,e)
Anna Conway, MSc (n)
Heather Hrushowy, BScN (n)
Paul R Kim, MD Ottawa ON Canada (a,e – Wright Medical
Technology)
Cobalt and chromium ion levels are elevated post
metal-on-metal hip resurfacing arthroplasty. They remain
elevated at 2 years post-op (median serum cobalt 1.6 ug/l
and chromium 3.3 ug/l).
Cobalt and chromium ion levels become elevated following
insertion of a metal on metal hip prosthesis. Few
studies have prospectively assessed ion levels following
hip resurfacing … Read the rest