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Metal-on-Metal Hip Implant Controversy Escalates

Metal-on-metal hip implants are at the center of controversy.

The debate surrounding metal-on-metal hip implants is quickly becoming as inflamed as the osteolytic tissue critics claim they cause.

In addition to their reputation for causing tissue inflammation, thereby leading to implant weakening and discomfort, all-metal implants have been linked in some recent reports to tumor formation as well. Consequently, although metal-on-metal hip implants have drawn fire for many years, protests and calls for action have significantly increased in recent months.

The past several months has seen a headline-grabbing editorial in the Journal of Arthroplasty in January that suggested avoiding the use of metal-on-metal implants followed by a high-profile New York Times article in March detailing the issue. We at MPMN also examined the controversy about metal-on-metal bearing surfaces, as well as other material combinations in our April cover story.

A medical device alert issued last month by the UK's Medicines and Healthcare Regulatory Agency (MHRA), however, could be a game changer. In the alert, MHRA acknowledged that "early revision of poorly performing metal-on-metal hip replacements should give a better revision outcome." It also requested that metal-on-metal implant patients undergo various follow-up tests to ensure health and safety. As a result of the alert, several British orthopedics organizations are even recommending that patients with metal-on-metal hip implants should be contacted and informed of the alert. If carried out, expect a panicked patient population to ensue.

But patients aren't the only ones in panic mode. Orthopedic implant OEMs are also on the defensive. Makers of metal-on-metal implants are issuing public statements, trying to put out fires, and restore faith in all-metal bearing surfaces. The Daily News in Memphis, which boasts a strong orthopedic device presence, reports that orthopedic OEM Smith & Nephew issued a press release today in support of its Birmingham hip-resurfacing system, claiming that it "is not like other metal-on-metal implants."

Could metal-on-metal implants' days be numbered? Is the MHRA's alert a nail in their coffin? What's next? Sound off in the comments section and let us know what you think.

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