According to recent guidance from the MHRA (Medicines and Healthcare Regulatory Authority), nearly 50,000 people with certain types of hip replacement implants require an annual blood test and in some cases also an MRI scan, following concerns that they can shed metal particles into surrounding tissue causing harm to the joint. Those with implants containing metal balls exceeding 36mm diameter were previously recommended to undergo blood tests only every five years, however these new guidelines coupled with the MRI scan, could detect a potential rise in ion levels indicating the need for a replacement implant.
The MHRA also commented that concerns regarding some metal-on-metal hip implants were first raised as far back as 2008 by surgeons who observed patients with the swelling and the DePuy ASR implant was banned by the MHRA. Critics however have accused the regulators of being slow to act against other metal-on-metal implants claiming that in a small number of cases, toxic chromium and cobalt ions have leaked into the lymph nodes, liver and kidneys before leaving the body as urine.
Following the guidance, The British Medical Journal published an article which alleged that hundreds of thousands of people around the world have been exposed to dangerously high levels of toxic metals in their bodies as a result of the introduction of metal-on-metal implants.
The MHRA did however state that patients with metal-on-metal hip replacement implants of less than 36mm in diameter (representing around 33% of the 65,000 fitted since 2003), would not require a blood test unless they were presenting symptoms, typically swelling in the hip area. However they advised patients who were unsure whether or not they had a metal-on-metal joint to seek advice from their GP.
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