‘Metal on metal’ hip alert after failure rate nearly doubled

CHECKS on all patients with “metal-on-metal” hips were prompted by a near-doubling in failure rates for the most common of the devices, records reveal.

The Medicines and Healthcare products Regulatory Agency (MHRA) issued an unprecedented alert on Thursday asking every patient with the implants to have X-rays and blood tests.

The watchdog said that the action was prompted by research showing that the devices are still causing soft tissue reactions, many years after their introduction. Analysis reveals the failings have prompted a near-doubling in the rate at which many devices are being removed. In total 56,000 of the devices have been fitted in recent years.

Data tracking almost 29,000 of the most common type of device shows that after being implanted for 12 years, 22 per cent have been removed – a rise from 12 per cent when they had only been implanted for five years. This compares with average revision rates of 6 per cent for all types of implants. The figures mean more than 6,300 patients with the uncemented devices have had to have extra operations – a rise from 3,500 five years before.

Similar patterns have been seen with other metal-on-metal hips, with overall rates of revision rising from 8 to 14 per cent over the period, the data from 38,000 devices shows. If trends continue, thousands more patients are likely to need revision surgery, after they have X-rays and blood tests to check for muscle and bone damage, and rates of toxins in the blood.

Dr David Langton, from the Freeman Hospital in Newcastle, said he was surprised that the MHRA had not acted faster. “Many surgeons have been warning them for years that patients with these hip replacements need regular testing,” he said, adding that some implants still work well.