HSE to order artificial hip review

Sunday 07 July 2013 16.43
Around 6,500 metal-on-metal hips were fitted to Irish patients
Around 6,500 metal-on-metal hips were fitted to Irish patients

The Heath Service Executive is to order a major review of all patients fitted with metal-on-metal artificial hips.

An estimated 6,500 of the devices have been fitted to Irish patients.

The move follows a similar investigation which was launched by the UK's medical devices regulatory agency, the MHRA, last year.

A metal-on-metal artificial hip is one where both the ball and socket joint are made from metal - often including the metals cobalt and/or chromium.

They were believed to be stronger than other varieties.

It is understood that the HSE will issue letters in the coming days to all regional directors of operations across the executive.

The letter will state that the HSE is planning on conducting a review of all the metal-on-metal hip devices sold and fitted in Ireland up to the current date.

The estimated 6,500 metal-on-metal hip devices fitted in Ireland include 3,500 ASR hip devices made by the manufacturer DePuy and a further 3,000 which were made by other manufactures, many of which are still being used.

The ASR devices were recalled by DePuy in 2010 after concerns were raised over their early failure rate, with more than 21% of the devices requiring revision surgery after five years, increasing to 23% after seven years, according to the UK's national joint registry 2012 report.

DePuy is facing approximately 600 lawsuits in Ireland in relation to the ASR device, while a further 300 cases are being taken against the HSE in relation to the purchase of ASR joints on behalf of public patients.

The company is also facing a significant number of lawsuits in the US, Australia and UK.

A new Irish national database of all knee and hip joint replacement surgeries will begin to log its first patients in September.

The Irish National Orthopaedic Register (INOR) is a joint initiative between the HSE and the Royal College of Surgeons.

Similar registries exist in the UK, Sweden, Australia and New Zealand and were credited with detecting issues with the ASR hip device prior to its recall.

The INOR will not only monitor the performance of medical devices but it will also monitor the activity of medical professionals who fit the devices as well as the institutions in which the hip replacement procedures are carried out, according to consultant orthopaedic surgeon Paddy Kenny who is leading the establishment of the unit.