New guidance has been issued for patients with metal-on-metal hip implants to prevent thousands of people suffering adverse complications.
Around 49,000 people have been given metal-on-metal hip implants, which can rub together and cause tiny metal particles to break off and seep into the blood. High levels of metal ions in the blood have been linked to cancer and neurological problems.
The Regulatory Agency has advised that people with metal-on-metal hip implants are checked every year.
Metal-on-metal implants are two to three times more likely to fail than ceramic ones, with one in eight needing to be replaced within 7 years.
One specific type of metal-on-metal implant, the ASR by DePuy, was recalled in August 2010 because it was linked to very high failure rates.
Previous guidance issued in 2010 by the Medicines and Healthcare Products Regulatory Agency said patients with metal-on-metal implants only needed to be followed up for 5 years.
But the Regulatory Agency has now issued new guidance, saying that all patients with metal hip implants made from a metal cup with a 36mm ball or larger should have regular blood tests to see if metal ions have leaked into the blood.
The test should be repeated every three months. If the metal ion level has risen the patient should be given a MRI scan to check for muscle damage.
People with very high levels of metal ions would have the hip replaced.
If the test shows that the level of metal ions is not rising, it should be repeated every year for as long as the patient has the implant. Patients who are already experiencing swelling, pain or other symptoms should be sent for an MRI and have the hip replaced as necessary.
Dr Susanne Ludgate, Clinical Director of the MHRA, said: "We recognise there is a toxicity association with very high levels of cobalt and chromium levels.
"As far as we can find there have been nine cases of patients who have had such high levels (of metal ions in the blood) that it has manifested itself in symptoms like neurological problems and in all these cases this was reversed when the hip was taken out."
Dr Ludgate advised that it is up to the orthopaedic surgeon to contact their patients and arrange these tests, but if people are worried they should visit their GP.
The Dr Foster Hospital Guide 2011 states that out of all the hospitals providing hip replacements four out of the top five are private. Care UK was rated the top independent provider, followed by Spire Healthcare, UK Specialist Hospitals, and Ramsay Healthcare UK.
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