Metal-on-Metal Hip Replacements

Medical Device Alert Explained

Metal-on-metal hip replacements have hit the headlines again, after The Medicines and Healthcare products Regulatory Agency (MHRA) issued a press release on 29th June 2017 recommending regular review of patients with these implants:

Hip replacements and Physiotherapy

A hip replacement is most commonly used to surgically treat a patient when their hip joint osteoarthritis has become so painful that it affects their normal activities of everyday living, work, hobbies, and quality of life. Physiotherapists play a key role in the patient’s journey both pre- and post-surgery.

Over the last 10 years or more we have seen advances in the rehabilitation of hip replacement patients with focus on early mobility. This was often known as ‘Enhanced Recovery’ and was combined with improved patient education prior to admission. We hear this label less and less now as this practice has become the norm in both NHS and private hospitals.

Medical Alert Explained

A diagram of a hip implantHip replacements are made of a variety of materials such as metal, plastic and ceramic.

Initially, whichever material you have in your hip replacement, you will have appointments to follow up with your physiotherapy and surgical teams. However patients with metal-on-metal hip replacements have been monitored more closely by surgeons since previous MHRA medical alerts in 2010 and 2012. These alerts are produced by an Expert Advisory Group.

Last month’s new medical alert continues the encouragement of appropriate follow up appointments for those patients with metal-on-metal hip replacements to ensure early detection of problems.  Orthopaedic surgeons are encouraged to closely monitor patients’ hips through relevant investigations such as blood tests, x-rays and scans.

It is important to note as highlighted in this guidance that ‘the majority of patients with metal-on-metal devices have well-functioning hips’, and patients may have no symptoms.  The guidance also states ‘The clinical advice we have received indicates patients will likely have the best outcomes if these problems are detected early, monitored and treated if necessary’.

If you have any questions or concerns regarding your hip replacement it is best to discuss with your surgeon, however the British Orthopedic Association’s website reports that these type of implants should now not be used, therefore if you have had hip replacement surgery since the issuing of these previous alerts you are unlikely to have a metal-on-metal hip replacement.

Further information can be found on the following websites: Arthritis Research UK, The British Orthopaedic Association, The National Joint Registry and NHS choices.

Posted in Hip and tagged .

Victoria Frosdick

Victoria is Lead Physiotherapist at Central Health Physiotherapy, based in St John's Wood. Vicky specialises in orthopaedic physiotherapy and rehabilitation. She has a special interest in enhanced recovery programmes for knee and hip replacements, shoulder surgery and fractured neck of femur rehabilitation.

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