Commentary: Metal on metal hipsBMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d3009 (Published 14 May 2011) Cite this as: BMJ 2011;342:d3009
All rapid responses
Rightly, much has been made in this issue of the BMJ of the laxity of
regulation in the licensing of prosthetic body components, especially hip
joints. It should be born in mind, however, that significant numbers of
failed hip replacements are due to surgical error, rather than to faulty
devices. Cups are quite often misaligned, and such misadventures as
extruded and hardened cement can cause severe pain, as I know from recent
An account of my original hip replacemtn may be found at
2313. It seemed fine for the first couple of months but then became
progressively more painful until I could scarcely stand or walk. Prior to
revision surgery, various scans and tests had suggested that the
prosthetic cup was misaligned, preventing outward rotation of my right
leg. When the revision surgery was performed, a shard of extruded,
hardened cement was found to be impinging on the soft tissue. There is no
reason to suppose that either the first or second metal-on-metal joints
were faulty in any way.
Competing interests: The author of this rapid response underwent emergency whole-hip replacement surgery in April 2010 and revision surgery in April 2011.The athor is patient editor of the BMJ.
Implant problems continue to haunt us. Could it be that there is
failure of the design and innovation process in addition to problems with
regulatory approval and post-marketing surveillance?
Would a form of warranty help improve confidence and help meet the
costs of failure?
Competing interests: No competing interests