I would like to take this opportunity to comment on the Lancet article, Failure rates of metal-on-metal hip resurfacings: analysis of data from the National Joint Registry for England and Wales, by Professor AW Blom, published on October 2, 2012.
There have been several press reports regarding the new MHRA (Medicines and Healthcare products Regulatory Agency) guidelines on metal-on-metal (MoM) hip replacements. We have had a number of enquiries from concerned patients.
Problem is, if no innovation at all is tried, how do we make progress? McMinn was way more responsible than most innovators and went to great lengths to iron out any 'bugs' in the BHR before he released it to open market.
There have been some recent articles in the press that have expressed some concern over Metal on metal and hip resurfacing in general. To someone just reading up on the procedure, these articles can be very misleading. Please keep in mind that the articles are written by a journalist (mainly Barry Meier) that wants to "sell" stories and not necessarily pass on good solid objective information.
These TV programs did a good job of bringing to attention the sad saga of failures with the ASR hip. Although the experience of only one Centre was highlighted, this experience with ASR failures is widespread.
Hip replacement has come a long way since the 1950s. It has improved to the point where middle aged or older patients can expect a relatively long life out of the implants if they follow certain restrictions and dont participate in high impact sports.
A few centres have reported a phenomenon, which has been named pseudotumors by a renowned orthopaedic hospital in Oxford. The term pseudotumor refers to a problem, whereby a hip resurfacing or a metal-on-metal hip replacement fails with a painful swelling or with collection of fluid around the hip joint. The word pseudotumor has caused consternation among patients who were worried if this is some kind of a hidden cancer or a pre-cancerous condition. These need to be put into perspective.
Six World Renowned Surgeons discuss concerns about Metal - metal Hip Resurfacing in Video Interviews
Internationally renowned hip and knee surgeon and designer and pioneer of the Birmingham Hip Resurfacing, Derek McMinn addresses concerns about Hip Resurfacing and Metal on Metal (MoM) implants
Mr. Derek McMinn Published Papers
I have used over 3000 metal bearings in primary total hip and hip resurfacing as well as revision surgery. I have revised 2 for adverse wear 7 years after implantation. I know that most other high volume hip resurfacing surgeons have a similar experience.
The original or very first resurfacing that we know of was made of solid Teflon on both sides. It was designed by John Charnley, who was dissatisfied with the results and changed instead to develop metal on plastic hip replacements.
I have now done over 1000 hip resurfacings. Practically all the Birmingham device marketed by Smith & Nephew. So I thought I would share what I think about the technique right now.