The quality of revisions for metal-on-metal hips has improved significantly in five years, according to an analysis published today.
Revision surgery for these implants now has similar outcomes to other types of revision surgery, according to the analysis from the National Joint Registry data.
The findings come after a fresh warning about the implants was issued last week by the Medicines and Healthcare products Regulatory Agency. This called for routine monitoring of patients with the implants even when there were no symptoms of complications.
Today’s analysis by Oxford University researchers involved some 2,535 patients who underwent revision surgery for reactions to metal.
It was backed by Arthritis Research UK and the Orthopaedics Trust and is to be published in The Bone and Joint Journal.
The researchers say increased surgical experience is responsible for the improved outcomes – and that potentially there could be further improvements.
Researcher Gulraj Matharu said: "Early studies in this area highlighted catastrophic short-term outcomes for patients undergoing revision for abnormal reactions to metal, with up to one third of patients requiring further surgery known as re-revision.
"Therefore, it is encouraging to observe substantially improved outcomes following hip revision surgery performed for abnormal reactions to metal. This is positive news as there are still many patients who have metal-on-metal hip replacements that may require revision surgery in the future."
He added: "Additionally, our findings identified risk factors associated with a poor outcome but which surgeons could actually modify during the revision procedure.
"Surgeons should therefore be mindful of these when making decisions regarding the type of hip reconstruction to perform. Doing so may help to further reduce the rate of subsequent failure following ARMD revision, which would be beneficial to our patients."
Which factors influence the rate of failure following metal-on-metal hip arthroplasty revision surgery performed for adverse reactions to metal debris? An analysis from the National Joint Registry for England and Wales. The Bone and Joint Journal In Press
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