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Already withdrawn in Australia and NZ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
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