I thought I would make a post before someone else does. We all have read that metal on metal devices are not being used, but this article said there is now a ban on them in the UK. It is, as far as I can tell, a ban on all devices except the BHR. This is very disturbing.
I wrote to Mr. McMinn's offce to get some more input before we take what is in the newspaper as gospel.
I know I am not supposed to print a full article, but I am going to do it until someone says to remove it since it is so important to all of us.
The article is
NHS hospitals to be banned from fitting metal-on-metal hip replacements after high failure rate
NHS hospitals are to be banned from fitting most metal-on-metal hip replacements after a study found unacceptably high failure rates among implants in 17, 000 patients
http://www.telegraph.co.uk/health/nhs/10406198/NHS-hospitals-to-be-banned-from-fitting-metal-on-metal-hip-replacements-after-high-failure-rate.htmlBy Laura Donnelly, Claire Newell and Holly Watt
9:57PM BST 25 Oct 2013
NHS hospitals are to be banned from fitting most metal-on-metal hip replacements after a study found unacceptably high failure rates among implants in 17,000 patients.
The devices have already been subject to safety alerts, amid fears they can leak toxic metal. Surgeons are concerned that they fail far too early as joints wear away.
Two common models have been taken off the market and thousands of patients fitted with the implants have been told to have annual checks, often including blood tests.
New draft guides drawn up by regulators say the NHS should stop using any hip implant with a failure rate higher than five per cent at five years. It means that almost every type of metal-on-metal hip implant - including five more devices still used - should no longer be fitted in patients.
The warning from the National Institute for Health and Care Excellence (Nice) has been issued after research uncovered failure rates as high as 43 per cent among some of the implants.
An audit of all hip surgery in England, Wales and Northern Ireland found that most types of metal-on-metal hip devices in use had failure levels below the standards Nice deems acceptable. The traditional varieties use a metal ball in a plastic socket.
One device, the DePuy ASR, which was withdrawn when manufacturers admitted to failure rates of 13 per cent within five years, required revision surgery in almost a quarter of cases within that period. After nine years, failure rates are estimated to be 43 per cent, the audit says.
When a similar model was used in hip resurfacing procedures — an operation introduced to achieve better results for younger, more active patients — failure rates were 14 per cent after five years, and 36 per cent after nine years. Both types of implants were given to almost 6,000 patients. Six metal-on-metal models and a ceramic-on-metal model implanted in more than 11,000 resurfacing patients had five-year failure rates of five per cent or worse.
Some rose to 16 per cent within nine years, the figures show.
The metal-on-metal resurfacing models found to have such high failure rates are: the Adept; Cormet 2000; Durom; Recap Magnum; and Conserve Plus.
A sixth device, the Corail/Pinnacle full hip replacement using ceramic on metal, also failed to meet the standard.
Just two types of metal-on-metal device in current use fall within the proposed national standard — and only barely — the figures show. Stephen Cannon, an honorary consultant surgeon for the Royal National Orthopaedic Hospital, welcomed the report.
He said: “I think there is a question about whether it goes far enough, but this is definitely a step in the right direction — it amounts to a ban on most of them.
“The figures speak for themselves — even the best metal-on-metals have four times the failure rate of the rest. This is a really significant problem because these were given to an awful lot of people.”
Senior surgeons said the full scale of the failings in hip replacements given to thousands of men and women was only now becoming clear. Martyn Porter, past president of the British Orthopaedic Association, said: “It first started to become apparent among surgeons about three years ago.
“We were starting to see high revision rates but this is like watching a car crash in slow motion — at first, you just don’t know how bad it is going to be.”
He said the scale of the problem was “extremely disappointing”. He said: “These devices, which were supposed to be innovative, had such poor results.”
Mr Porter said any patients who suspected problems with a metal-on-metal device should see their doctor.
“The important thing is identifying and investigating the cases where there are problems because if you leave it too long it can cause tissue destruction.”
Senior surgeons said their results still compared badly with those of traditional hip replacements. Some called for all types of the implant to be forced off the market.
The devices were introduced in the 1990s, but became most popular among surgeons over the past decade, with more than 11,000 a year being implanted by 2008 because it was hoped that they would offer better results.
DePuy said rates of revision on its Corail/Pinnacle ceramic-on-metal device might be lower than five per cent when data confidence intervals were taken into account.
Corin, the makers of Cormet 2000, said it had produced excellent clinical outcomes since being introduced in 1997. The manufacturers of Adept, Durom, Recap Magnum and Conserve Plus did not respond to calls.