In 1993 a BMJ editorial warned of the “fashion trade” in joint replacements (BMJ 1993;306:732). It said this was costing health services many millions of pounds each year and causing patients pain and distress through early failure of unproved implants. This week an investigation by the BMJ and Channel 4 Dispatches shows how right this view was and how little has changed.

As Deborah Cohen describes (doi:10.1136/bmj.d2905), one particular “metal on metal” hip implant has been used in more than 93 000 patients since its approval in Europe in 2003. It was withdrawn last year. In the intervening years, the manufacturer ignored concerns raised by surgeons and registries about …