Metal on Metal Arthroplasty

Dr. R. CoupWhangarei Hospital

ObjectivesRecent Concerns

Prevention

Approach to Patient

ASR Recall August 2010

“Voluntary”

British Journal

bad results ASR

Already withdrawn in Australia and NZ

Every joint replacement entered in registry.

NZ since 1999

Australia 2001

Australian registry

Failure

Reaction to metal debris

Effects local not systemic

Raised chromium and cobalt levels

Soft tissue mass

Bone destruction

Most important surgical factor

Choice of implant

Registry data

General Practice

ASR Introduced 2003

Very few in Northland

Other designs MoM

Pain continuing after hip replacement

Operation note

Contact Surgeon

Await Clinic Appointment

Infection

Peri- prosthetic fracture

cRP, X-ray rather than ion levels

Pain persisting

No plan

2nd opinion

Thank you