The United Kingdom National Health Service is banning surgeons from using metal-on-metal hip replacement systems in patients, based on guidance issued from consumer health watchdog the National Institute for Health and Care Excellence (NICE). The consumer health advocacy group developed the guidelines after investigations and research into the all-metal implants, which were found to have a startling high premature failure rate.
Traditional hip implants are made with plastic or ceramic parts and generally last about 25 years before needing to be replaced. In the past decade, medical device manufacturers introduced all-metal artificial hips, assuming the devices would hold up better over time. However, the devices were found to fail at a faster than expected rate. The latest studies show that the all-metal devices have a failure rate of about 43 percent during a span of nine years.
When artificial hips fail, they generally loosen, dislocate or cause the bone to fracture, often requiring revision surgery to remove and replace the device. Revision surgeries are more invasive and require more recovery than initial hip replacement surgery. Surgeons also found that all-metal hip implants can corrode inside the body, damaging and inflaming tissue surrounding the joint space. In some cases, metal ions can leech into the bloodstream causing a type of blood poisoning known as metallosis.
Thousands of lawsuits have been filed against the manufacturers of all-metal hip implants, including DePuy Orthopaedics, a subsidiary of Johnson & Johnson, which recalled its faulty metal-on-metal ASR hip replacement system in 2010 following a rash of complaints.
Since problems with metal hips have come to light, many surgeons around the world have opted not to use them, so it is likely the UK’s ban on metal hip implants was a welcome step for both surgeons and their patients.