Tuesday, December 13, 2011

Hip Replacement Devices are All the Same, Study Says

Hip replacement implants all work the same regardless of the material used, according to a new study.
The newer, metal-on-metal implants appear to be no more effective than older implants and may sometimes even be more problematic, the researchers said, according to HealthDay News.

"Metal-on-metal and ceramic-on-ceramic hip implants might not be associated with any advantage, compared with traditional bearings such as metal-on-polyethylene or ceramic-on-polyethylene," lead researcher Dr. Art Sedrakyan, director of the Patient-Centered Comparative Effectiveness Program at Weill Cornell Medical College in New York City, told HealthDay.

While there is some evidence from three large national registries that higher rates of replacement surgery are associated with metal-on-metal implants, compared with metal-on-polyethylene implants, there is simply not enough information about these implants to determine if one type is better or safer than the other, Sedrakyan continued. Even for newer implants such as metal-on-metal or ceramic-on-ceramic bearings, their advantage over traditional implants is not clear, he told HealthDay.

"There are very successful implants on the market today for hip replacement," Sedrakyan told HealthDay. "We need to have stronger data on improvement in clinical outcomes for new hip implants."
Sedrakyan and his colleagues, along with the U.S. Food and Drug Administration, looked at the safety and effectiveness of various types of hip replacements in 18 studies that included more than 3,000 patients and 800,000 operations. The researchers found no difference between the various types of implants in terms of the patients' quality of life or ability to function normally.

Dr. Peter Cram, an associate professor of medicine in the division of internal medicine at the University of Iowa Carver College of Medicine, told HealthDay: "The study highlights a critical issue in joint replacement surgery, which is there is not a lot of good data."

The best way for patients to ensure they are getting the best implant is to seek out “an experienced surgeon, who does lots of these procedures, in a hospital that does lots of these procedures," Cram added.

Dr. Joseph Zuckerman, professor of orthopedic surgery and chair of the orthopaedic surgery department at NYU Langone Medical Center in New York City, told HealthDay: "This study confirms what many surgeons already practice -- that in the pursuit of providing the best outcome, a surgeon must base his or her treatment recommendation on important factors that include each individual patient's health status and lifestyle, their own clinical experience, the documented evidence about outcomes, and the available technology."

This study was published in the Nov. 29 online edition of the BMJ

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