May 8, 2012 — Health Canada, a federal agency that advocates for the health of Canadians, has issued a new warning about the risks associated with metal-on-metal hip implants. An estimated 10% of Canadians with hip implants have the metal-on-metal design. Health Canada is warning these people and their doctors to be on the lookout for symptoms that the device is causing health problems.
Studies have linked the metal-on-metal hip implant design to an increased risk of failure and side effects compared to metal-on-plastic or metal-on-ceramic, yet the devices continue to be implanted in people. The most recent study of this device has found that it corrodes more quickly and severely compared to plastic devices. There is also evidence that the metal-on-metal parts may grind together and shed metal ions into surrounding tissues. This can severely damage the tissues surrounding the implant, which increases the likelihood that the device will fail.
Health Canada is advising patients who have problems with their metal hip implant to undergo blood tests to check for dangerously elevated levels of chromium or cobalt in the bloodstream. Metal hip implants have caused severe metallosis, metal poisoning, and cobalt poisoning in some patients.
Patients should watch out for symptoms of a severe problem. Symptoms include pain and swelling in the legs, hip, groin, or joint. Symptoms may also include decreased range of motion, changes in gait, abnormal limp, or changes in walking ability.
Metal-on-metal hip implants are a relatively new medical device. There is very little long-term safety information. When the devices were approved by the FDA, the manufacturers avoided conducting long-term safety studies because the metal-on-metal design was “substantially similar” to plastic and ceramic designs. By the time several studies found that the metal hip implants were more likely to fail and had other severe side effects, hundreds of thousands of people all over the world had already received the products.
Health Canada is warning that new recipients of a metal hip implant should be monitored periodically for at least five years to watch for signs of early failure or metallosis. They are also warning that it appears risk factors include being obese, physically active, female, and having a metal hip implant in both hips.
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