Hip disease - replacement prostheses (TA2)
Fast, easy summary view of NICE guidance on 'hip fracture'
In June 2012 the advice about the follow-up of people with metal on metal hip replacements changed (see medical device alert MDA/2012/036 from the Medicines and Healthcare products Regulatory Agency [MHRA]). People with metal on metal hip replacements should talk to their doctor for more information.
Based on the evidence, NICE has recommended to the NHS that:
- Wherever possible, the NHS should use artificial hip joints that can show they last for 10 years or more. This is called a benchmark.
- Sometimes a surgeon might need to use an artificial hip that does not meet this benchmark. If this is the case, the hip should have at least 3 years evidence. This evidence should show that the artificial hip is on target to meet the 10-year benchmark.
- Artificial hips that do not meet the standards 1 and 2 above should only be used in the NHS as part of a clinical trial. If you need one of these hips, then your surgeon will discuss the details of the clinical trial with you before you agree to have the operation.
- Artificial hips are described in one of three ways: cemented, uncemented or hybrid. It depends on the design of the artificial hip and how it is fixed into the bone, during the operation. There is more evidence that cemented artificial hips meet the 10-year benchmark (described in point 1) and produce the least pain and discomfort.
- To help the NHS establish and do the best for their THR patients more evidence on the performance of artificial hip joints and THRs
is needed. Therefore, NICE has recommended that the NHS should set up a hip registry and should encourage more research. This may mean that the NHS and your surgeon will collect information about your hip operation and how well you have progressed.
- TA2 Hip disease - replacement prostheses: guidance (web format)
- TA2 Hip disease - replacement prostheses: questions and answers
This guidance has been incorporated into the following NICE Pathways, along with other related guidance and products.
Visit the NICE Pathway: hip fracture
- Hip disease - replacement prostheses: review decision - August 2011
- Review Proposal - June 2011
- Hip disease - replacement prostheses: appeal
- Review decision - July 2009
- Review decision - July 2009: appendix 1 proposal comment summary table
- Review Proposal - May 2009
- Review decision (September 2005)
- Review proposal (February 2005)
- Letter to consultees on review proposal following discussion meeting at NICE
- Review of NICE Technology Appraisal Guidance No 2 - Guidance on the selection of prostheses for primary total hip replacement
- Hip Prostheses Assessment Report
This page was last updated: 04 January 2013
- Web format
- Full Guidance (PDF)
- TA2 Arweiniad ar Ddethol Cymalau Gosod ar gyfer Clun Cyfan Newydd Cyntaf: deall canllawiau NICE
Information for the public
In response to paragraph 7.1 of the guidance, the NHS Purchasing and Supply Agency (PASA) entered into consultation with the British Orthopaedic Association, British Hip Society and the Association of Healthcare Industries to establish:
- A transparent process for collecting and evaluating evidence of prosthetic hip revision rates
- Benchmarking data to enable interpretation and implementation of the guidance.
- As a result, the Orthopaedic Data Evaluation Panel (ODEP) was established in 2002. ODEP is now hosted by NHS Supply Chain following the decommissioning of NHS PASA. Information regarding its operation and a full list of prostheses and their rating in relation to the benchmarks may be found at www.supplychain.nhs.uk/odep
Implementation tools and resources
- None available
See this guidance in practice
The summary of the key recommendations in the guidance written for patients, carers and those with little medical knowledge and may be used in local patient information leaflets.
Quick Reference Guide
The quick reference guide presents recommendations for health professionals
The published NICE clinical guidance, contains the recommendations for health professionals and NHS bodies.
The published full clinical guidance for specialists with background, evidence, recommendations and methods used.