Concern about metal on metal hip prostheses: reflections from the work of Sir John Charnley

BMJ 2011; 343 doi: (Published 10 October 2011) Cite this as: BMJ 2011;343:d5148
  1. Thomas Tull, core trainee year 1, Imperial College NHS Trust, London,
  2. Patrick J Venables, professor, Kennedy Institute of Rheumatology, Charing Cross Hospital, London ,
  3. Sonya M Abraham, senior lecturer, Division of Medicine, Imperial College London
  1. s.abraham{at}

The recent recall of a metal on metal (MoM) hip prosthesis by Depuy Orthopaedics has caused concern about the long term viability of this type of joint replacement. The ASR XL Acetabular Hip System and DePuy ASR Hip Resurfacing System were withdrawn from the market in 2010 because of high failure rates1 caused by inflammatory soft tissue reactions to metallic wear debris. Such wear debris causes cell necrosis in tissues surrounding the joint, which is not seen in other types of prosthesis, and results in early failure of the prosthesis. Of further concern are the raised levels …

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