Information on metal on metal hip replacements

There have recently been stories in the national media around advice from the Medicines and Healthcare products Regulatory Agency (MHRA) that patients who have undergone large head metal-on-metal hip replacements should be monitored annually for life. This follows previous advice published in 2010 by the same agency that suggested that hip resurfacings should be reviewed on a yearly basis for the first five years after implantation.

UHCW can confirm that it believes that 15% of its patients receiving hip replacement operations (approximately 800) have received either metal on metal hip replacements or hip resurfacing since 2003 and it will be writing to all patients who have had hip replacements to offer advice and reassurance.

Patients who have not had metal on metal hip replacements will have this confirmed and their current follow up arrangements will not change.

Those patients with metal on metal hip replacements will now be reviewed on an annual basis as per the MHRA recommendations.

It is worth noting that since 1995, when the first hip resurfacing was performed in Coventry, all cases have been followed up annually in a dedicated clinic. In addition, since 2008 the Trust has held a “Groin Pain Clinic”, which takes place on a quarterly basis, to assist any patients who have had discomfort following hip resurfacings. Among other investigations the patients attending this clinic have their bloods taken to measure the metal ion levels and an ultrasound scan of the hip.

Our surgeons stopped using conventional hip replacements with metal on metal bearings about 18 months ago. However, they are still using hip resurfacings for the right patient and indications. Further to this, three of our Orthopaedic Consultants Steven Krikler, Udai Prakash and Pedro Foguet are co-authors of a scientific paper soon to be published which shows that the hip resurfacing system used in patients at UHCW (The Cormet resurfacing) has a survivorship of more than 90% after 10 years, which is regarded as the ‘gold standard’.

A Trust spokesman said: “Hip replacement continues to be one of the most successful operations that any doctor of any specialty can perform.”

“There are thousands of patients in the UK that have Metal on Metal hip replacements and the vast majority of them had their lives transformed by the surgery which not only took away most of their pain but also improved their mobility so that they could go back to enjoying a full and active lifestyle.

“A team of consultants, nurses and administrative staff are now looking back over the patient records so we collate a full list of anyone we think may be affected and write to them individually to reassure and advise them.”