The report was released by the National Joint Registry for England and Wales (found online at njrcentre.org.uk), and reported by The New York Times (09/15/11). According to the report, the DePuy ASR, an all-metal hip, failed in approximately one-third of the patients who had been followed for the longest period. Meanwhile, the same report indicated that other metal-on-metal hip replacement devices had a significantly higher early failure rate than hip replacement devices made from other materials.
Metal-on-metal hip replacement devices use both a ball and socket that are made of metal. They were designed to be more durable than traditional hip replacement devices that often included a ceramic or plastic component. Concerns about the all-metal devices, however, are that metal debris can come loose from the joint and be absorbed by the patient's tissue, causing a condition known as metallosis.
Typically, artificial hips are expected to last around 15 years before replacement. Some reports indicate that the all-metal hips are failing with alarming frequency after five or six years. Failure of a hip implant device often causes extreme pain and mobility issues, and may require the patient to undergo revision surgery, which comes with added risk of complications.
According to The New York Times (08/22/11), which analyzed data from the US Food and Drug Administration (FDA) reporting system, the FDA received more complaints about all-metal hips between January and June 2011 than it had in the previous four years combined. The agency reportedly received more than 5,000 reports of problems with the all-metal hips since the beginning of 2011. The increase in complaints resulted in the FDA requiring makers of the all-metal devices to study the frequency with which they were failing and what implications that would have for patients.
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In its report, the Joint Registry noted, "Some studies have raised concerns about metal-on-metal implants in terms of higher revision rates and poorer patient outcomes (related to pain and function) compared with other bearing surfaces. In particular, there are concerns about the possibility of metal debris damage to soft tissue surrounding the joint (metallosis) and the uncertain effects of any release of cobalt and chromium ions into the patient's blood." The Joint Registry goes on to note that while the results for the ASR are worse than for the all-metal group as a whole, even when the ASR results are excluded, the all-metal group still has a high revision rate.