We just blogged a few days ago about the hip replacement side effects from metal-on-metal (MOM) hip implants, and already there’s a new complication to toss on the MOM hip implant garbage heap. During the American Academy of Orthopaedic Surgeons annual meeting this week, presenter Dr. Stephen Graves shared research results concluding that the risk of heart failure in men nearly doubled after they’d received a metal-on-metal (MOM) hip implant.
When combined with the massive pile of other hip replacement side effects, some of which follow, we have to again ask, Why do surgeons keep using MOM hip implants?
A Review of the Hip Replacement Side Effects from MOM Hip Implants
While we can hope that the addition of this newest complication—the risk of heart failure in men—attributed to a MOM hip implant will open the eyes of orthopedic surgeons still using these implants, the reality is that they will probably continue to use them. It’s hard to understand why when we review some of the complications we could reach in and pull out of the growing MOM hip implant pile (more details and studies on these complications can be found through this link):
- Pain—In one research study, 35% of patients reported pain and also showed significantly higher cobalt and chromium blood levels compared to patients without pain. Patients with the lowest cobalt levels reported significantly less pain and significantly better outcomes on functional measures. Hip replacements are supposed to be done to reduce pain and increase function, but with the correlation between higher blood levels of metal ions in the blood and more pain and poorer outcome, the odds are good that this is no coincidence.
- Genetic defects—Chromosomes can be damaged by wear debris from hip replacement metals, and if that happens, your cells receive bad instructions for how to make the chemicals that keep you alive, leading to genetic problems. While joint replacement wear debris causing inflammation and elevating serum metal levels is bad enough, having that debris mess with your chromosomes is a huge problem.
- Cobalt and chromium toxicity— Hip replacement cobalt toxicity, or elevated cobalt levels, from metal-on-metal hip implants are a serious problem, but many doctors miss the signs and symptoms of cobalt poisoning. Animal studies have shown that high cobalt metal levels can affect the nerves in the eye. Hearing and vision loss are also commonly associated symptoms with both chromium and cobalt toxicity.
- Revisions—Revisions can be a result of many complications. A hip replacement revision is when the surgeon has to repair or remove an implant. Revisions of metal-on-metal hip implants can be effective for reducing metal ions in the blood, though some metals can remain in the blood even after the implant is removed.Think about this for a moment—in some cases after the offending metal is removed, there’s still a problem!
- Pseudotumors/tissue irritation—The metal shavings from the metal-on-metal hip implant can fill the joint area and irritate surrounding tissues. In addition to causing those high metal ions in the blood serum, black soot-like metal particles can develop from these shavings. These soot-like particles can cause strange tissue reactions, sometimes creating what looks like a tumor (pseudotumor). Pseudotumors can become very big—golf ball sized or larger—and press on the nerves, arteries, and veins near the hip joint, causing pain and other problems.
The FDA Reveals Hip Replacement Side Effects from MOM Hip Implants
We’ve been following hip replacement side effects due to metal-on-metal implants for years. In 2013, we shared with readers that the FDA was clamping down on MOM hip implants due to many complications found during their review of more than 100 studies. The FDA’s action plan for metal-on-metal hip implants, last updated online in April of 2015, further confirms what we’ve been reporting. The action plan addresses concerns of metal particles wearing off of the implant and entering the bloodstream, corrosion of the device, damage to bone and tissue around the implant, pain, implant loosening, and implant failure leading to revision of the surgery (removal of the old implant and replacing it with a new one).
The FDA link above states, “Different people will react to these metal particles in different ways. At this time, it is not possible to predict who will experience a reaction, what type of reaction they might have, when the reaction will occur, or how severe the reaction will be.” Currently, their recommendation is for patients to see their surgeons immediately when they experience symptoms and for MOM hip implant patients without symptoms to have regular follow-up visits with their surgeons to monitor their MOM implant. We can only hope as the complications continue to mount that the FDA will consider more drastic actions regarding these MOM hip implants in the future.
Are There Alternatives to MOM Hip Implants?
There are alternatives to MOM hip implants, which is why it is so dumbfounding that surgeons continue using them. While there are many hip replacement materials that may offer alternatives, metal on polyethylene, ceramic on metal, ceramic on ceramic, and ceramic on polyethylene, they all carry some degree of complications. You might want to learn more about how stem cells stack up against hip replacements.
The upshot? You’d think this growing pile of hip replacement side effects from MOM hip implants would generate enough garbage to discontinue their use, but manufacturers just keep making them and surgeons just keep using them. Maybe they’ll add heart failure to their list-of-potential-risks speech they give patients or in the fine print on their patients’ informed consent forms—after all, the surgeons have to protect themselves—but why not just stop using MOM hip implants?