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M. Brandon Smith
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Should Metal on Metal Hip Implant Devices Be Completely Banned In United States

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Ever since DePuy Orthopaedics, a division of Johnson & Johnson, recalled nearly 93,000 of their ASR metal-on-metal hip implant devices in August of 2010 there has been a near constant stream of news about the risks of these metal-on-metal devices and the horror stories of patient suffering.

The issues with these hip implant devices seem to be endless: the risk of metallosis or cobalt poisoning (more here, here, and here), the extremely and unacceptably high failure rate of the devices, how doctors and surgeons downplayed these risks (and here), and questions about the FDA approval process, among others.

Now, surgeons and physicians are starting to take a stand and call for the complete end to the use of metal-on-metal hip replacements. The BBC News reports that the British Hip Society is saying that patients should no longer receive all-metal hip replacements because of the life-long risks that the devices pose. That same report indicates that the problems with all-metal devices don’t actually come as a surprise—but that the problems have been known for decades.

While regulators—such as the Medicines and Healthcare products Regulatory Agency—claim that the implants can still be used, those agencies also recommend that patients will need lifelong monitoring on an annual basis. That monitoring includes blood tests to check for metal debris and scans to detect raised metal levels and adverse symptoms.

The British Hip Society backs its position with some fairly strong evidence. As reported on Zeenews.com, concerns are particularly high for individuals with large-diameter total hip replacements. The Society points to countless patients who have suffered pain, swelling of the joints and damaged tissue around the implant. Some physician members of the British Orthopaedic Association are joining in the call to cease use of the metal-on-metal devices. But their concern isn’t just about the risk of metal debris. Their concern is that these devices promised to be more durable, yet the rate for revision surgeries is over double compared to traditional hip replacement implants.

As more and more information comes out about these metal-on-metal devices, ceasing their use completely starts to make sense. The risks are great and there doesn’t appear to be any increased benefit.. Only time will surely tell but I think everyone, including orthopaedic surgeons, sees the writing on the wall that MoM devices may be a thing of the past in terms of the medical commumnity and their patients.