Negative study on metal prostheses for hip joints

British doctors demand ban on metal prostheses for hip joints

13.03.2012

According to a recent study, artificial hip joints of metal fail earlier than previously thought. British researchers are calling for a ban on metal implants. In Germany, the Federal Institute for Drugs and Medical Devices (BfArM) is currently conducting a risk assessment of the so-called "metal-on-metal hip endoprostheses".

German risk assessment for hip implants not yet completed
In the renowned journal „The Lancet“ The British scientists write that data analysis has clearly shown that metal-on-metal implants will result in more hip surgery faster than other products on the market. As a result, the researchers are calling for a ban on metal-on-metal hip implants. In addition, it is better to test medical products longer and more thoroughly before they are approved.

In Germany, the Federal Institute for Drugs and Medical Devices (BfArM) is currently conducting a risk assessment. According to the BfArM, the authority was in contact with the English health authority MHRA and medical societies and manufacturers. „The aim is to be able to reliably limit potential health risks for patients. "The medical associations DGOOC and DGU have already been informed by the BfArM about extended aftercare recommendations, which were published in February as recommendations of a group of experts from the MHRA extended the recommended follow-up period for certain prosthesis types from five years to the prosthesis wearing time.

So-called metal-to-metal joint implants have long been reputed to be particularly stable and durable. They were mainly used in very active patients. But implants have been suspected for a long time that they can not keep what they promise. Therefore, British researchers led by Alison Smith of the University of Bristol evaluated the data from approximately 402,000 hip operations from 2003 to 2011 in England and Wales. They found out that in about 31,200 cases said metal-on-metal hip implants were used. The remaining operations used alternative models made of ceramic or polyethylene, for example. About six percent of the metal-to-metal hip replacements had to be replaced after five years because people complained of health complaints. In the case of alternative models, only about two percent had to be exchanged.

Metal abrasion can cause inflammation
The British scientists also found that the size of the articular surfaces of metal-on-metal prostheses was crucial. The larger the area, the higher the risk that the prosthesis needs to be replaced. In the case of alternative ceramic models, the researchers were able to determine the opposite. The larger the articular surfaces, the longer the shelf life.

In the case of discredited prostheses, a metal condyle sits in a metal acetabulum. The rubbing together of the metal parts can cause a toxic abrasion that can cause inflammation. „All patients who have such implants should be well monitored, "the researchers write „The Lancet“. Doctors should monitor affected patients with annual blood tests. In the blood can be determined whether metal compounds have entered the body of the person concerned.

The BfArM reported that the medical societies, which include the German Society for Orthopedics and Orthopedic Surgery (DGOOC) and the German Society for Trauma Surgery (DGU), have been informed that extended follow-up recommendations have been issued for those affected. „For example, the recommended follow-up period for certain types of prostheses was extended from five years to the prosthesis wearing time. "

Today, almost every elderly person receives a knee or hip prosthesis
For some time, the figures for hip and knee prostheses in Germany have increased significantly. Experts are already saying that soon almost every elderly person in the Federal Republic will need a prosthesis of the knee or the hip. For a rough estimate of 30 million pensioners, these are worrying figures. Here, experts from the field of naturopathy ask the question, why the health insurance companies continue to often refuse to pay for alternative methods such as osteopathy. In many cases, these much gentler treatments could save a lot of money. In addition, the side effects of the treatments for the patient are much lower. An operation is always and especially for the elderly a risk dar. Of course, alternative methods can not provide relief in any case, but they could contribute to healing as a supplement to conventional medicine. (Ag)