Most hip joint replacements are metal on plastic, but in the past several years, metal-on-metal hips have become popular due to the potential benefits of longer term use. This has been the hope for the new hips, but it has been dashed by concerns about complications from these prostheses. In particular there is premature deterioration of the hip joints, release of metal into the bloodstream, and local inflammation surrounding the hip replacement leading to pain, reduced mobility, and disability.
The FDA has just released recommendations for monitoring that will provide clearer guidance for patients and physicians.
The FDA has released this information here. Review this ‘plain-english’ position statement:
New metal-on-metal and ceramic-on-ceramic hip joints have been criticized of late, particularly with the meta-on-metal hips causing metal to leak into surrounding tissues and the bloodstream, resulting in pain and questionable metal toxicity. Revisions are needed in some cases and this has been an unanticipated consequence of this new technology, as report in the New York Times.
This study, looking at the old metal-on-plastic hips, showed that they were equal to the new joints, and perhaps slightly better as they required less revision surgery over time. This information came from an overview of 18 different studies involving 3400 hip replacements.