Checks needed for Patients with Metal Hip Replacements

Philip Stott

A leading surgeon is urging patients in Brighton and Hove/Sussex who believe they have a metal-on-metal hip replacement to get checked out.

Philip Stott, an orthopaedic consultant who specialises in hip and pelvic surgery, says that while most people are unlikely to have any problems, it is better to err on the side of caution as a faulty prosthesis could cause long term health and mobility problems.

He explains: “One of the problems with hip replacements is that they can wear out. The basic parts of hip replacements are a cup, which is attached to the pelvis and a ball, which is attached to the top of the leg. The first artificial hips had metal balls with plastic cups, which wore out very quickly. Over time the materials became more varied and better made, but one solution became the most popular: a metal ball in a metal cup. But this is also the combination of materials that has become the most problematic.

“As the metal surfaces rub together, they can release small particles of metal into the bloodstream. While the kidneys can filter out small amounts of this metal, if the patient has a particularly badly wearing joint, then these levels can often become too much for the body to remove.

“One of the first things to happen is inflammation around the hip, causing a build up of fluid around the joint. Usually it goes unnoticed, but I have met some patients that describe the feeling like sitting on a golf ball, while others describing a deep ache within the area, with the discomfort usually more noticeable at night.

“Eventually the patient will be unable to lie in certain positions and moving will start to become painful. In extreme cases, the hip can become dislocated, resulting in a trip to the hospital to have it put ‘back in’.

“If you suspect you may have a problem, you first need to confirm you have a metal-on-metal replacement. If you still feel the joint needs investigation then contact your local NHS hospital or GP who will be able to help, or put you in touch with an expert.

“These investigations usually involve an x-ray and other non-invasive methods of diagnosis. The outcome of the tests will determine what needs to be done, which could range from needing the hip replaced, to no action being needed at all.”