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    Metal-on-Metal Hip Implants Have Higher Fail Rates

    Study: All-Metal Hip Replacements Fail Faster Than Other Types

    Keep It in Perspective

    Experts who were not involved in the study had mixed reactions to the results.

    Joshua J. Jacobs, MD, chairman of the department of orthopedic surgery at Chicago’s Rush University, and a vice president of the American Academy of Orthopedic Surgeons, said the findings should be kept in perspective.

    “This clearly is a higher [failure] rate in some metal-on-metal large head-hip replacements compared to other bearing combinations,” Jacobs says.

    But, he says, the vast majority of patients still have good results with their metal implants after five years.

    “It’s not like half of the implants are failing or even a quarter or even 10%. It’s in the area of 6%. That’s not what we as orthopedic surgeons want. We would like a 0% failure rate at five years. That’s what we strive for in our patients, and we know we can’t get that just because of the nature of the surgery,” says Jacobs, who has consulted for orthopedic manufacturers in the past. He says he hasn’t received any personal support from device manufacturers in more than a year.

    But other studies have shown that failure rates for metal-on-metal implants rise the longer a patient has the joint.

    Some studies have shown nearly twice as many patients with metal-on-metal implants need corrective surgeries as patients who get joints made from other materials.

    Patient Advice

    Jacobs says patients with metal-on-metal implants should return to their surgeon for regular checkups, even if they aren’t having any problems.

    Patients who are having pain or difficulty walking or moving should see their doctors immediately.

    Other experts think the issue is more urgent.

    “We have half a million patients who have metal-on-metal hips in the U.S. We need to focus investigation on this issue,” says Art Sedrakyan, MD, PhD, an orthopedic surgeon at Weill Cornell Medical College in New York.

    Sedrakyan wrote a commentary on the study but was not involved in the research.

    Based on this study and mounting evidence against metal-on-metal designs, Sedrakyan says use of the implants should stop.

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