• Get hip: The truth about hip implant safety.

      The media has recently identified the early failure of certain metal-on-metal hip implants as a modern peril in our rush to adopt new technologies. The problem with many of these reports, however, is that the few journalists have provided the proper context required for a reasonable assessment of hip implants over the past 40 years.

      Today, a total hip replacement is one of the most successful orthopedic reconstructive procedures. 85- 90% continue to function well at 20 years, allowing most individuals to remain active for decades. So where then do the problems arise?

      This becomes a story of distinction. The majority of hip implants used today are not the metal-on-metal variety, but rather metal-on-polyethylene (plastic) or ceramic on polyethylene. Metal-on-polyethylene implants are the most commonly used replacements, as well as the oldest. Surface wear and loosening is what causes failure after years of use. Doctors have spent years looking to reduce the amount of wear and instability in these devices. Ceramic on ceramic implants wore well, but a small percentage squeaked and recent use has decreased. Metal-on-metal implants were proposed as a way to introduce an implant that not only reduced the wear but more closely matched the size of the normal hip; allowing a greater range of motion. It soon became clear, however, there were a host of major issues associated with metal-on-metal implants: severe inflammatory responses, the detection of metal ions in the blood stream, and a greater rate of wear and loosening, which can lead to the formation of cysts around the prostheses.

      The New York Times and others have spotlighted the toll that the widespread use of metal-on-metal hip implants has had on individuals, physicians, and yes, even insurers. They point out the need for unforgiving precision when inserting these prostheses. Metal-on-metal implants may still be required but care must be taken in order to minimize the chance of complications.

      To recap, there is great concern about metal-on-metal prostheses, and they should not be used unless it is necessary, and even then, only by the most accomplished hip surgeons. That is not to say that anyone currently with a metal-on-metal prostheses should replace it with polyethylene or ceramic, but rather, anyone with a hip replacement should be evaluated if there is increased pain, grinding and any changes in how the hip feels.

      BE AWARE AND INFORMED. If you’re a patient of Manhattan Orthopedic and Sports Medicine Group, you can be confident knowing that we have never used metal-on-metal implants and only use the most proven tools and techniques for all of our procedures.