Hip disease - metal on metal hip resurfacing (TA44)
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.
NICE has made the following recommendations about the use of metal on metal (MoM) hip resurfacing.
- MoM hip resurfacing is recommended as an option for people with advanced hip disease who would otherwise receive a conventional primary total hip replacement (THR) and are likely to live longer than the device is likely to last.
When considering MoM hip resurfacing surgeons should bear in mind:
- how active the individual is
- that the evidence available at the moment for the clinical effectiveness and cost effectiveness of MoM hip resurfacing comes mainly from studies that have involved people less than 65 years of age. ('Clinical effectiveness' means how well MoM hip resurfacing works, and 'cost effectiveness' mean how well it works in relation to how much it costs.)
- Information on MoM resurfacing operations carried out should be collected as part of a UK national joint registry. The information collected will help the NHS to gather evidence on both the clinical effectiveness and cost effectiveness of MoM hip resurfacing.
- The data from the national joint registry will allow researchers to find out how long MoM hip resurfacing devices last before they need to be replaced. Until more long-term evidence is available, NICE recommends that surgeons should choose a device for MoM resurfacing for which there is at least 3 years' evidence. This evidence should show that the device is likely to meet a target of less than 1 in 10 devices needing replacing over 10 years.
- MoM hip resurfacing should be performed only by surgeons who have received training in the technique.
- Surgeons should make sure that people considering having MoM hip resurfacing understand all the risks and benefits associated with it, and are aware that less is known about the safety and reliability of MoM devices than about conventional cup and ball THR devices.
- TA44 Hip disease - metal on metal hip resurfacing: guidance (web format)
- TA44 Hip disease - metal on metal hip resurfacing: summary
- Hip disease - metal on metal hip resurfacing: review decision - August 2011
- Review proposal - June 2011
- Review decision - July 2009
- Review Proposal - May 2009
- Review Proposal - May 2009: Appendix A - provisional matrix
- Review decision (September 2005)
- Letter to consultees on review proposal following discussion meeting at NICE
- Review proposal (February 2005)
- Health technology assessment report
This page was last updated: 04 January 2013
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