Metal-on-metal total hip replacements have shown a number of adverse effects.^1-3 Some recipients of these hip replacements have complained of severe pain and immobility after tiny metal fragments have chipped off and damaged surrounding tissue. As a result, many who receive metal-on-metal hip replacements have elevated blood levels of chromium and cobalt, two metals used in these hip replacements.¹ There has also been a greater need for revision surgery, a procedure where surgeons must re-open the hip for repair.³ Another hip arthritis treatment is hip resurfacing. Instead of completely replacing the hip joint, metal “caps” are placed on the articular surfaces of the femur and pelvic socket.

New Concerns of Pseudotumors with Hip Replacements

A surgeon in the Netherlands recently published an article discussing new concerns of pseudotumors developing around the hip replacement or resurfaced site⁴. These pseudotumors have the appearance of tumors and can wreak havoc on the joint area. They are caused by an adverse reaction to metal debris, as in a local metal allergy or sensitivity. Patients who present with pseudotumors experience soft tissue masses in the groin, pain, swelling and discomfort in the leg and groin and compression of the neurovascular bundle (nerves, arteries, veins and lymphatics that travel together). The development of pseudotumors has caused some surface replacement to be recalled from the markets and medical registries in England, Wales, New Zealand and Australia have all seen increases in rates of revision arthroplasties. Both the British Orthopaedic Association and the Dutch Orthopeadic Association have issued strong warning on the metal treatments for hip arthritis, with the Dutch recommending a complete cessation of using hip resurfacing and hip replacements. The doctor who authored this article stated that all of his patients who received a metal-on-metal hip replacement are called back for clinical examination and screening for the possibility of a pseudotumor. He performs a radiological exam, a serum cobalt and chromium ion analysis and a CT scan for soft tissue reactions around the artificial joint.

Prevent Hip Replacement with Prolotherapy

Clearly the long-term effects of metal-on-metal hip replacements are poor and an alternative must be encouraged. While hip osteoarthritis is a problem, we believe that far too many people undergo needless hip replacements. If there is enough motion in the joint Prolotherapy can help regenerate cartilage in a degenerated hip. Prolotherapy is a safe and effective conservative alternative to surgery. Whenever a person is told that a hip replacement is the only option, they should most definitely get a second opinion. We recommend a Prolotherapist’s opinion.

1. Meier B, Roberts J. (August 22 2011).Hip Implant Complaints Surge, Even as the Dangers Are Studied. New York Times online. Retrieved from http://www.nytimes.com/2011/08/23/business/complaints-soar-on-hip-implants-as-dangers-are-studied.html?_r=1&pagewanted=all
2. Knoix, R. Prone To Failure, Some All-Metal Hip Implants Need To Be Removed Early.
3. http://www.npr.org/blogs/health/2012/03/19/148769073/prone-to-failure-some-all-metal-hip-implants-need-to-be-removed-early. Accessed 3/7/2012.
4. Bates, C. Hope, J. Toxic metal hip implants ‘could affect thousands more people than PIP breast scandal’. http://www.dailymail.co.uk/health/article-2107640/Toxic-metal-hip-implants-affect-thousands-people-PIP-breast-scandal.html. Accessed 3/7/2012
5. Van Raay JJ. Metal-on-Metal Total Hip Arthroplasty: Known and Unknown Side Effects. Orthopedics. 2012: 35 (6).