Growing Concerns over Metal-on-Metal Hip Implants

Many the top orthopedic surgeons around the world have either stopped or reduced their use of metal-on-metal hip implants. The popular devices that once thought to be world beaters have lost support from many physicians over concerns that the devices may cause severe tissue and bone damage, often requiring revision surgery.

In recent years, metal on metal hip implants accounted for about a third of the 250,000 annual hip implant surgeries. Metal on metal devices gained popularity because of the belief that they would be more durable than more conventional products; however, emerging research has shown that this may not be the case.

Recent studies have shown that in some instances metal on metal devices can begin to wear quickly, creating metallic debris that is absorbed by the body. This can cause inflammation, pain, tissue death, and bone loss in the surrounding area.

Doctors at leading orthopedic centers like Rush University Medical Center in Chicago and the Mayo Clinic in Rochester, Minn., say they have treated a number of patients over the last year with problems related to the metal debris.

Studies suggest that women are more susceptible to these problems than men.

The creation of debris caused friction is not unique to metal on metal hip implants. All hip implant devices will produce some debris; however, it is believed by some metal on metal implants may produce much more and more dangerous debris than plastic-metal combination devices.

According to the recent New York Times article and Dr. Harlan C. Amstutz, an orthopedic surgeon from Los Angeles, the problem is related to both design and technique.

It is not clear whether some makers’ devices are more prone to the debris problem than others. But some experts argue that some manufacturers, in a rush to meet the demand for metal-on-metal devices, marketed some poorly designed implants and that some doctors fail to properly implant even well-designed ones.