Metal-on-metal hip replacement toxicity: opinions from the UK

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Additional material for NPS article Monitoring for potential toxicity in patients with metal-on-metal hip prostheses: advice for health professionals.

The UK-based National Joint Registry in their 2011 Annual Report noted that MoM implants with bearing diameter ≥ 36 mm may be considered problematic and are associated with 'a potentially marked increase in failure' at approximately the 6th year in stemmed implants with MoM bearing surfaces'.

The British Orthopaedic Association recommends regular screening for at least 5 years and possibly for the life of the MoM prosthesis. The Association recommends clinicians consider symptoms of pain and investigate appropriately. In addition, large-diameter MoM bearings in THR should be carefully considered and possibly avoided due to current evidence.

View the British Orthopaedic Association position statement Large Diameter Metal on Metal Bearing Total Hip Replacements.