Saturday, September 1, 2012

Measuring Cancer risk 4 years post implant with MOM hips

 2012 Jul 25;345:e4646. doi: 10.1136/bmj.e4646.

Risk of cancer with metal-on-metal hip replacements: population based study.

Source

Department of Orthopaedics and Traumatology, Surgical Hospital, Turku University Hospital, FI-20701, Turku, Finland.

Abstract

OBJECTIVE:

To assess the risk of cancer associated with modern primary metal-on-metal hip replacements.

DESIGN:

Population based study.

SETTING:

Nationwide retrospective comparative register.

PARTICIPANTS:

10 728 patients who underwent metal-on-metal total hip arthroplasty and 18 235 patients who underwent conventional metal-on-polyethylene, ceramic-on-polyethylene, and ceramic-on-ceramic total hip arthroplasty (the non-metal-on-metal cohort) in the Finnish ArthroplastyRegister 2001-10. Data on cancer cases up to 2010 for these cohorts were extracted from the Finnish Cancer Registry.

MAIN OUTCOME MEASURES:

The relative risk of cancer was expressed as the ratio of observed to expected number of cases from the Finnish population-that is, the standardised incidence ratio. The relative risk of cancer in the metal-on-metal cohort compared with the non-metal-on-metalcohort was estimated with analyses of these ratios and Poisson regression.

RESULTS:

The overall risk of cancer in patients with metal-on-metal hip implants was similar to that in the Finnish population (378 observed v 400 expected, standardised incidence ratio 0.95, 95% confidence interval 0.85 to 1.04). The overall risk of cancer in patients with metal-on-metal hipimplants was also no higher than in patients who had received non-metal-on-metal hip implants (relative risk 0.92, 0.81 to 1.05).

CONCLUSIONS:

Metal-on-metal hip replacements are not associated with an increased overall risk of cancer during a mean follow-up of four years.
 
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I don't think you are going to find cancer 4 years post artheroplasty.  I think we have done enough short term studies on this now.  We have to start looking at patents 10 years post artheroplastsy.
 

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