Interesting story on NPR yesterday which featured the problems being seen with metal on metal (MOM) hip replacements. The controversy about hip implant side effects centers around wear particles, which can cause local tissue reaction and even get into the blood stream. These wear particles are created as the patient moves the new hip and are seen with all types of hip replacements including plastic and ceramic as well.
Hip resurfacing is the most common type of implant where a MOM hip device is commonly used, and hip resurfacing complications are well publicized though many patients considering hip resurfacing don’t seem to consider this in their decision to get the surgery. The story featured a patient who had to have the implant removed and the hip fused because the wear particles had caused so much bone formation around the hip. On the other side of the coin, surgeons swear by the implants and feel that the side effects are minor. I’ve blogged on the complication rate for hip replacement, which like knee replacement stands at about 10%. In addition, a surprising number of patients after joint replacement still have pain. In fact, I examined one of these patients yesterday. This gentleman still has disabling knee pain despite a knee replacement and regrettably that’s getting worse, so we’re trying to figure out if it’s due to the prosthesis loosening, just common and untreated myofscial tissues, an allergy to the metal in the prosthesis, or something thats gone undetected like a pinched nerve in his back.
The upshot? Buyer beware with metal on metal hip replacements that are commonly used for hip resurfacing. While all of these hip devices suffer from the problem of wear particles, MOM hips seem to be the worst of the bunch.
About the Author
Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…