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
Pat Walter from Surface Hippies contacted me. I want to make it clear that I am not a qualified pathologist, nor a medical doctor, I am just a researcher with an interest in hip resurfacing and biomaterial compatibility. I run an independent implant retrieval research laboratory within the J. Vernon Luck Snr MD Orthopaedic Research Center at UCLA/Orthopaedic Hospital in Los Angeles. As such, I am the fortunate recipient of specimens and information from several orthopaedic surgeons, including Dr De Smet, who care enough about their patients to seek out knowledge to help solve patient problems, among which is metal sensitivity. I also want to emphasize that metal sensitivity to hip resurfacing replacements (or other hip replacements) is a problem that we (the orthopaedic community) are still learning about. (as well as the very much more common causes of problems with hip resurfacing such as fracture and loosening). Therefore, … Read the rest
Can I have a Hip Resurfacing if I am Allergic To Metals?Skin allergies to metals does not mean you will be allergic to a hip resurfacing device inside your body at the deep tissue level. This is a question that many people ask. The best way to know if you can have a hip resurfacing when you have skin allergies to metals is to ask an experienced hip resurfacing surgeon.Dr. Bose has written this explanation about the metal allergy problem: “Allergy after artificial joints is an interesting issue. One must keep in mind that the co-cr-mo alloy has been in clinical use for 45 yrs and is present in 99% of all hip and knee replacement surgery. Even if a component is titanium the articulating part would be always co-cr-mo. Therefore metal sensitivity is not exclusive to metal on metal joints. It is a factor in every joint… Read the rest
Question from poster:
Hi, I am 32 years old and had CDH and hip displasia. My blood test revealed that I have a metal allergy, so total hip replacement is the only option for me. jing
Answer from Gord RathboneI had a reaction to both chrome and cobalt, in preliminary skin tests, prior to BHR 5 & 1/2 years ago. After considerable help from Keith Brewster and other research came to the conclusion summarized by
that an internal tissue reaction is not something to worry about, being statistically much less likely than being struck by lightning. If this is presented as an obstacle to this excellent surgical solution of a hip resurfacing, you should seek a second opinion, particularly at your young age.
Gord Rathbone … Read the rest