Concerns about metal on metal hip implant systems have been prevalent for many years in the United States, with many patients reporting they had to undergo revision surgery sooner than they were led to expect. Due to the fact that there are no plastic or ceramic barriers between the all metal hip implant components, patients could be at risk for serious post surgical complications.

The concerns about metal on metal hip implant systems raise concerns about hip revision surgery success rates in conjunction with these devices, with the FDA stating that these hip implants may increase the possibility of revision surgery.

Metal on metal hip implants consists of all-metal ball and socket joint components, , typically made of cobalt and chromium, that are supposed to function like a natural joint. Patients typically undergo hip replacement surgery after suffering some kind of bone deterioration or injury, which rendered their bones unusable or severely damaged.

While metal on metal hip implants were supposed to be more durable than ceramic or plastic models, they have become associated with serious device complications that require revision surgery.

Hip revision surgery involves replacing the previous prosthetic after a problem develops from wear and tear, loosening, or other problems like infection. The defective device, the surrounding tissue and dead bone around the device must be removed so the new hip replacement product can be implanted.

It is important to note that revision surgery has a lower success rate compared to the initial implant surgery because the bone is weaker. According to Cedars Sinai, complications from hip revision surgery include:

• Infection
• Device Loosening
• Bone Fracture after Surgery (due to greater amount of scar tissue)
• Dislocation (twice as common than in initial procedure)
• Leg Length Disparity
• Bone Loss in Joint

Overview of Metal on Metal Hip Implant Complications

Concerns about metal on metal hip implant systems stem from the ball and socket joint components shedding metal ions into the bloodstream.

These metal ions can cause a multitude of problems for the patient and increase the risk of certain long term health problems like cancer and cardiomyopathy. Device complications linked with metal on metal hip implants include:

• Metallosis (blood metal poisoning)
• Infection
• Fretting
• Corrosion
• Debilitating Pain
• Limited Movement
• Formation of Pseudotumors

According to the Hospital for Special Surgery, these device complications often forced patients to undergo revision surgery, which is often the only treatment method for these problems. There are approximately 18 hip revision surgeries for every 100 hip replacement surgeries, with the most common reasons for revision surgeries being:

• • Repetitive Dislocation of Hip Replacement
  • Implant Wear and Tear
  • Infection

With this in mind, it is important for doctors to evaluate the risk of the potential need for revision surgery when recommending metal on metal hip implants. The FDA issued a post market surveillance study of metal on metal hip implants on May 6, 2011, stating that the study would monitor any injury reports regarding related post surgical complications.

This was to evaluate the safety profile of these devices, and to warn patients and the medical community that they should be wary of potential device failure.

The FDA issued an update to this metal hip warning on Jan. 17, 2013, stating that devices with metal ball and socket joint components could face complications related to metallosis.