Lessons of a hip failure

If we want improved prostheses we must regulate their use

News p 650

The hazard warning issued this month by the Medical Devices Agency in Britain on the 3M Capital hip system evoked emotion but no surprise among hip surgeons.1 Previous reports of failures have suggested the need for better surveillance,2 and five years ago a BMJ editorial warned, presciently, “This ‘fashion trade’ in joint replacements is costing the health service many millions of pounds each year and, even more important, is causing patients unnecessary pain and distress through early failure of unproved implants.”3 The 3M Capital hip was introduced in 1991 as a low cost hip replacement. Adverse reviews have already been reported, and its failure rates of 19-21% at five years1 are four times what would normally be expected and suggest an intrinsic problem. Yet over six years 4669 have been implanted in 95 centres throughout Britain. For a new and untested hip to have ben introduced into so many clinical centres in such a short …