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Wright Metal on Metal Hip Implants
Metal-on-metal bearings for hip surgery have been in clinical use for more than 20 years, mostly with good results. A small percentage or less than 1 percent of patients may develop inflammation. Lately, a more severe inflammatory response called pseudotumor has been reported.
A Canadian study was recently conducted to determine the prevalence of pseudotumor following metal-on-metal hip resurfacing in Canadian academic centers.
The advantages of metal-on-metal hip systems are to provide hip implant patients with durability, range of motion and joint stability for younger, more active patients. These metal to metal implants are made of a cobalt-chrome alloy. The ball and socket can be manufactured to closely match the size of the patient’s own joint, allowing for more natural functioning.
However, disadvantages and risks include metallic debris that might lodge in tissues surrounding the joint, metallic ions that travel through the body in the bloodstream, and possible dislocation of the joint. Replacement also known as revision surgery is necessary if there is a problem.
But back to Canada, nine of the 14 centers that perform metal-on-metal hip resurfacings were surveyed. At the nine centers, 3,432 hip resurfacing surgeries were performed; 76.9% of the patients were male, the mean age was 51.2 years (range, 16 to 83 years), and the mean body-mass index was 28.1 (range, 17 to 55). The mean length of follow-up was 3.4 years (range, two to 9 years). A pseudotumor developed after four of the 3,432 surgery, for a prevalence of 0.10%.
In conclusion, although pseudotumors remain a concern after metal-on-metal hip resurfacing, the prevalence at short to midterm follow-up is very low in this multicenter survey. Continued close monitoring is required to determine what clinical factors are involved with the uncommon pseudotumor formation.
However, if you are in the percentage of patients who do suffer from pseudotumors caused by Wright metal on metal hip cup implants – the problem is real and may require legal intervention.
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