See below for links relating to hip replacements published on this site prior to 2016.
Newer articles and videos are situated on the main Links page.
Please see also the tabs to the left providing links to articles from MRHA, TGA, News coverage, Knee replacements and Papers.
Please note we are not responsible for the content of external websites.
FDA Ordered Postmarket Studies to Better Understand Safety Issues, and Many Studies Are Ongoing
The US Government Accountability Office (GAO) report on which the link below is based.
1/2 GAO study finds 510(k)-cleared devices account for 94% of unplanned postmarket safety studies
The GAO (US Government Accountability Office) study analyzed the 313 postapproval market studies and 392 postmarket surveillance studies conducted between 2007 and February 2015.
Australian Orthopaedic Association Annual Report 2015
Australian Joint Registry releases 2015 annual reports on hips, knees, shoulders and more.
FDA slaps most serious label on MicroPort hip implant device recall
China's MicroPort earned the FDA's most serious designation over a recall of devices used in hip joint replacement surgery after reports surfaced that showed the products could be endangering patients' lives.
Launch of the World report on ageing and health
From The World Health Organization.
FDA's new patient-centric advisory committee to provide additional input on device regulation
Article in FierceMedicalDevices. The FDA's device arm (CDRH) announced the launch of the Patient Engagement Advisory Committee to provide additional perspective on topics like patient preference information, risk-benefit determinations and device labeling. The move is an attempt to ensure that the actual users of devices can influence decision-making, in addition to industry and the medical community.
2015 National Joint Registry is now published.
Zimmer Biomet expands joint preservation procedure into foot and ankle markets
FierceMedicalDevices article. Zimmer Biomet has widened its patented and trademarked surgical procedure subchondroplasty into use for foot and ankle joints. The company acquired the technology in its 2013 purchase of Knee Creations for an undisclosed amount.
Tornier, Wright merger to close soon after foot and ankle implant divestiture
Tornier just announced a divestiture needed to secure completion of its $3.3 billion merger with Wright Medical. Integra Lifesciences will acquire Tornier's ankle and toe replacement orthopedic devices in the U.S. for an undisclosed amount. It also gained an option to purchase the ex-U.S. rights to Tornier's toe replacement devices.
China FDA signs off on 3-D printed hip implants
FierceMedicalDevices article. The Chinese Food and Drug Administration (CFDA) approved 3-D printed hip implants in China, encouraging innovation amid an increasingly stringent regulatory environment.
Postapproval Studies of High-Risk Therapeutic Medical Devices.
High risk medical devices backed by few studies
Many high-risk therapeutic devices get Food and Drug Administration (FDA) approval with only one study proving their safety and efficacy before going to market.
FDA approves the first implantable, above-the-knee prosthesis
The OPRA (Osseointegrated Prostheses for the Rehabilitation of Amputees) Implant System, as the newly approved prosthetic is known, is from Swedish bone-anchored prosthetic specialist Integrum AB. Article published in FierceMedicalDevices
NSF spends almost $31M to develop dissolvable metal surgical implants
The National Science Foundation has been investing this research money since 2008 in an effort to develop what it has dubbed "smart implants" that address the underlying medical issue but then dissolve. (Article published by FierceMedicalDevices).
Budget 2015: our concerns about changes to the welfare system
Read Arthritis Research UK's verdict on how Budget2015 could affect people with arthritis.
Medical device makers beef up product guarantees to woo U.S. hospitals
An article published by Reuters. Medical device makers, facing sluggish sales and increasing pressure to prove the value of their products, are beefing up guarantees to compensate U.S. hospitals if a device does not perform as expected. Medtronic Plc, Johnson & Johnson and St Jude Medical Inc are among the first to provide the newer guarantees. Orthopedic implant makers are exploring such agreements for hip and knee devices.
Study: Web-Based Tutorials Can Help Patients Better Understand Orthopedic Procedures
First-time surgery can be concerning to any patient. Knee surgery—even arthroscopic surgery to treat a torn meniscus—can require significant preparation and rehabilitation. According to a new study appearing in the June 17 issue of The Journal of Bone & Joint Surgery (JBJS), a Web-based tutorial can not only increase a patient’s understanding of the surgery but also provide a better experience. Article by Orthopedic Design and Technology.
From Australia "Expert review of medicines and medical devices regulation - first report released"
Review of Medicines and Medical Devices: Stage One Report covers recommendations on the regulatory frameworks for medicines and medical devices.
Daily walking 'does not have a negative impact on knee osteoarthritis'
New study discussed by Arthritis Research UK.
A new study initiated this month by five leading research funders and institutions will estimate the health and economic benefits of UK investment in medical research into musculoskeletal conditions.
UK BBC Radio 4 "You and Yours"
Consumer affairs programme features metal-on-metal hips.
Raising Transparency of Pricing for Total Hip and Total Knee Replacements
This link provides access to letter from Professor Tim Briggs outlining the price ranges currently being paid by English NHS Trusts for a number of types of hip and knee prosthetic joints.
Why a national implant registry is vital for patient safety
The controversy around PIP breast implants highlights the need for robust systems to track and monitor quality across all surgical devices, says Andy Gordon Jones.
The revision burden for THA is 52% greater than for TKA, but revision TKAs are increasing at a faster rate (article in Clinical Orthopaedics and Related Research).
Is a Revision a Revision? An Analysis of National Arthroplasty Registries’ Definitions of Revision
The reported survival of implants depends on the definition used for the endpoint. Revision, which is the most common main endpoint used by arthroplasty registries, is not universally defined. This implies that some reoperations that are considered a revision in one registry are not considered a revision in another registry. Therefore, comparisons of implant performance using data from different registries have to be performed with caution.
Middle-age hip replacements nearly double from 2002-2011, outpacing growth in elderly population
Continued growth in hip replacement utilization in patients age 45 to 64, and need for revision surgeries as these patients age, could present significant challenges related to cost and access. The number of total hip replacements (THRs) nearly doubled among middle-aged patients between 2002-2011, primarily due to the expansion of the middle-aged population in the U.S., according to a new study presented at the 2015 Annual Meeting of the American Academy of Orthopaedic Surgeons. Continued growth in utilization of hip replacement surgery in patients age 45 to 64, an increase in revision surgeries for this population as they age, and a nearly 30 percent decline in the number of surgeons who perform THR, could have significant implications for future health care costs, THR demand and access.
Rheumatoid arthritis is an inflammatory disease, mainly affecting joints and tendons. An inflamed joint looks swollen and red, and appears warm to the touch. The disease usually starts in the wrists, hands or feet, and can spread to other joints and other parts of the body. Rheumatoid arthritis is an autoimmune disease that causes inflammation in your joints. The main symptoms are joint pain and swelling. Learn more and download a booklet from the Arthirtis Care site on the link above.
Diagnosing arthritis in children
Research at Newcastle University has sped up the diagnosis of arthritis in children.
New device could stop rheumatoid arthritis pain without pills
Researchers are testing out a possible new treatment for rheumatoid arthritis that doesn’t require taking any pills. The device is surgically inserted into a patient’s neck, where it rests against a nerve. Patients turn the device on for three minutes each day using a magnet. It then sends electrical impulses that reduce the number of immune cells that travel to joints, causing painful inflammation.
Precaution, governance and the failure of medical implants: the ASR(TM) hip in the UK
The failure rate of the Articular Surface Replacement metal-on-metal hip system, implanted almost 100,000 times world-wide, has re-opened debate about appropriate and timely implant governance. Published in Life Sciences, Society and Policy.
Are Metal-on-Metal hip implants safe?
This fact sheet is based on the Opinion of the independent Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR): “The safety of Metal-on-Metal joint replacements with a particular focus on hip implants".
Rheumatoid arthritis sufferers offered hope after electrical implants leave patients 'pain free'
Article from The Independant. People suffering from rheumatoid arthritis have been given new hope after some patients fitted with electrical implants reported they had become “pain free
ARUK: Which joints are affected by osteoarthritis?
Osteoarthritis can affect any joint, especially if it’s been badly injured. The most commonly affected joints are: knees, hips, neck and back, big toes and hands.
"Unique Device Identifiers (UDIs): A Roadmap for Effective Implementation"
The U.S. Food and Drug Administration (FDA) is establishing a national unique device identification system to adequately identify medical devices through their distribution and use. When the system is fully implemented, the label of most devices will include a unique device identifier (UDI) in human- and machine-readable form. Article by Brookings.
Metal on Metal Toxicity from Hip Implants
A video showing a presentation given by Dr. Stephen Tower at Healthwatch USA
Arthritis Today: Sugary Sodas May Raise Rheumatoid Arthritis Risk
A new study finds a link between sugar-sweetened soda and rheumatoid arthritis risk
National Rhuematoid and Arthritis Society (NRAS) have updated their 'What is RA' article
An article by the NRAS to find out more about rheumatoid arthritis
Musculoskeletal conditions can have a huge impact on people’s lives. They may not take life, but for many they take away the quality of life. Prevent, Transform, Cure – the Arthritis Research UK manifesto calls for decision makers to put in place policies that will lead to the prevention and cure of musculoskeletal conditions while transforming the service provided to those that live with them.
From Australia "Medical Devices Safety Update"
This article includes a section on joint replacements and their results
This review will be performed to identify areas of unnecessary, duplicative, or ineffective regulation that could be removed or streamlined without undermining the safety or quality of therapeutic goods available in Australia; and opportunities to enhance the regulatory framework so that Australia continues to be well positioned to respond effectively to global trends in the development, manufacture, marketing and regulation of therapeutic goods.
From the EU: "Final opinion on Metal-on-Metal joint replacements"
The European Commission has mandated the Scientific Committee on Emerging Newly Identified Health Risks to produce an opinion on “the safety of Metal-on-Metal joint replacements with a particular focus on hip implants”.
Further investigation needed for assessment, treatment protocols of ASR implants
Among patients with Articular Surface Replacement metal-on-metal hip products, the relationship between MRI pathology, metal ion levels and acetabular inclination angles remains unclear, and further investigation is required for setting up protocols for assessment and treatment, according to researchers.
Article published in Clinical Orthopaedics and Related Research. Metal-on-metal (MoM) total hip arthroplasties (THAs) and the head-neck and neck-body junctions in modular THA are associated with a variety of local and systemic reactions to their related wear and corrosion products.
Titan Spine offers first spine implant warranty
This is the orthopedics industry's second product warranty in the U.S. Titan Spine announced that it's becoming the first spine implant manufacturer to offer a warranty on its products. The 5-year warranty of its Endoskeleton line of spinal interbody fusion devices is the orthopedics industry's second product guarantee, joining Biomet's lifetime warranty of its Oxford Partial Knee.
Arthritis Research UK (ARUK) understand that we must address how we reduce the risk of developing a musculoskeletal condition, alongside how we reduce the impact of these painful conditions once they've developed. More information and PDFs are available at the link above.
Medical Device Registries: Recommendations for Advancing Safety and Public Health
In 2012, FDA issued a report, “Strengthening Our National System for Medical Device Postmarket Surveillance,” outlining four key steps for creating a national surveillance system that would quickly identify poorly performing medical devices. One step was to encourage the development of national and international device registries, which contain information on patients who use or are treated with a specific device. The report outlines five objectives for stakeholders to work toward so that medical device registries can better contribute to the national surveillance system. More information is given in the link provided above.
Invited comments of Prof. Tom Joyce, Newcastle University on the article below
Clinical Orthopaedics and Related Research invited Prof. Tom Joyce to comment on 'The John Charnley Award: Highly Crosslinked Polyethylene in Total Hip Arthroplasty Decreases Long-term Wear: A Double-blind Randomized Trial'.
Healthline: The effects of rheumatoid arthritis on the body
This article discusses the effects of rheumatoid arthritis on the whole body including the Circulatory System, Skin, Eyes and Mouth along with the skeletal system.
Australia's government could save more than $1 billion over four years if prices for medical devices such as pacemakers and hip joints were brought into line with those paid in other countries, private health insurers contend.
Orthopedic Design and Technology Magazine: "Is the Hip Implant Market Improving?"
The hip replacement market is beginning to recover from the global recession and controversies surrounding metal-on-metal implants, with procedure volumes growing and patient confidence at an all-time high, according to an analyst with United Kingdom-based research and consulting firm GlobalData.
Intellijoint’s Hip Replacement Positioning System Cleared in U.S.
Intellijoint Surgical (Waterloo, ON) won FDA clearance for its Intellijoint HIP system that’s used to help orthopedic surgeons measure leg length and hip offset during hip replacements.
Biomedical engineering: advancing UK healthcare report
This report by the Institution of Mechanical Engineers gives an overview of biomedical engineering in the UK and includes case studies from UK universities and industry. It looks at the role of technology and biomedical engineers in the NHS, and makes a number of key recommendations, which would help improve healthcare in the UK and stimulate grow in the sector.
Revisions of Monoblock Metal-on-metal THAs Have High Early Complication Rates
A relatively high percentage of monoblock metal-on-metal total hip arthroplasties (THAs) undergo early revision. Revision of these THAs poses challenges unique to this implant type. Article published in Clinical Orthopaedics and Related Research.
Cementing broken hips leads to fewer deaths
British Orthopeadic Association response to Telegraph regarding the use of bone cement
The Walking Wounded - Background Information
After the ABC Four Cornerd TV programme in Australia, some valuable background informationis given including some of DePuy's test data
Four Corners TV programme Australia, update on ASR metal-on-metal hip
From India: "CBI probe into faulty hip-implant case mooted" relating to ASR metal-on-metal hip
The Food and Drug Administration (FDA) of Maharashtra has recommended an investigation by the Central Bureau of Investigation in the faulty ASR hip-implant case
FDA Approval of Cardiac Implantable Electronic Devices
An important paper from JAMA discussing how the US Food and Drug Administration (FDA) evaluates high-risk medical devices such as cardiac implantable electronic devices (CIEDs)
EFORT 2013 e-Science Congress Session Online
The mid term survival of Birmingham Synergy total hip replacements
Improving Medical Device Regulation: The United States and Europe in Perspective
Recent debates and events have brought into question the effectiveness of existing regulatory frameworks for medical devices in the United States and Europe to ensure their performance, safety, and quality.
Cobalt poisoning by hip replacement: Arthroprosthetic-Cobaltism
Article by Dr. Stephen Tower discusses cobalt poisoning after metal implants
Seven million Americans are living with an artificial knee or hip
2 percent of Americans have new hips or knees. Results reported at an American Academy of Orthopaedic Surgeons conference in New Orleans
VIDEO presentation: The Dangers of Metal-on-Metal Hip Implants
Slides presented by Dr. Steven Tower at Health Watch USA Meeting - From Alaska over Adobe Connect
Feb. 19, 2014
Hip Replacement Implant Materials
There is no consensus in the orthopedic community regarding the single “best” bearing or material. Only a qualified orthopedic surgeon can determine which implant system is best for your unique situation. There are many factors your surgeon uses when recommending hip implants. Be sure to ask questions and share any concerns you might have regarding specific implants with your surgeon early in the process
Among overweight and obese adults with knee osteoarthritis, after 18 months, participants in the diet + exercise and diet groups had more weight loss and greater reductions in IL-6 levels than those in the exercise group; those in the diet group had greater reductions in knee compressive force than those in the exercise group
Exercise therapy may postpone total hip replacement surgery in patients with hip osteoarthritis
A long-term follow-up of a randomised trial suggests that exercise therapy in addition to patient education can reduce the need for THR by 44% in patients with hip osteoarthritis
Fractures of a Single Design of Highly Cross-Linked Polyethylene Acetabular Liners
From Arthroplasty Watch. Researchers investigating 74 reports of fractured liners in a single design (Trilogy Longevity Zimmer) voluntarily filed to the FDA concluded that liners less than 7 mm thick at the weight bearing or 4.8 mm thick at the rim of this design should be used with caution
Blood cobalt levels, device type may predict metal-on-metal hip failure
Elevated concentrations of cobalt in the blood and device type may predict early failure of metal-on-metal hip replacements, according to researchers from the United Kingdom
Women less likely than men to have hip replacement
One in ten Australian women will have total hip replacement surgery during their lifetime, but women still lag behind males in rates of joint replacement for hip osteoarthritis, research suggests
The lifetime risk of THR for females was similar to males
Arthritis Research UK. Shoulder and elbow replacement
Arthritis Research UK article. Do you need a shoulder or elbow replacement? Read more about the surgery at the link above.
Failure rate of cemented and uncemented total hip replacement
YouTube presentation posted by BMJ
Europe CE Approval Process for Medical Devices
Useful summary of "Europe CE Approval Process for Medical Devices"
Johnson & Johnson Shifting from Devices to Drugs in 2014
Drugmaker Johnson & Johnson is shifting its focus from medical devices and diagnostic equipment to pharmaceuticals
National Public Radio (US) on DePuy ASR settlement
Patients, Consumer Advocates Question Hip Implant Settlement
BioPen to rewrite orthopaedic implants
A handheld ‘bio pen’ developed in the labs of the University of Wollongong (UOW) will allow surgeons to design customised implants on-site and at the time of surgery
BBC: New genetic clues for rheumatoid arthritis 'cure'
An international team of researchers has found more than 40 new areas in DNA that increase the risk of rheumatoid arthritis
FDA Announces Improvements To The Medical Device Recalls Database
The Food and Drug Administration (FDA), Center for Devices and Radiological Health (CDRH) has announced improvements to several public databases that will increase access to safety information on marketed medical devices
Experience with ASR metal hip joint
Dr Steven Tower, orthopaedic surgeon and recipient of ASR metal hip talks of his experiences in a 1-hour video
Reuters: "EU Parliament stops short of U.S.-style approvals for medical devices"
The EU parliament backed plans for tighter monitoring of device manufacturers
Orthopaedic Product News article on symposium discussing ways to improve and evolve today’s orthopaedics devices and implants
A useful summary of total hip replacement
About the hip joint and hip replacement
Researchers have concluded that intra-articular injections of hyaluronic acid for the treatment of knee osteoarthritis significantly improve pain and function compared to placebo
Patients who receive medical implants are becoming younger and expecting more - but are there risks?
Trends in the ages of patients undergoing hip surgery
Industry-funded studies on HA present more favorable conclusions
An article discussing a paper in press presenting results on the use of hyaluronic acid injections in patients with osteoarthritis of the knee.
Ultrasound recommended
Commentary on "High Prevalence of Pseudotumors" article
Commentary on the article below
Investigation into the occurence of pseudotumors (lesions that are neither malignant nor infective in the soft tissues surrounding total hip arthroplasty components) after hip arthroplasties with metal-on-metal bearings
Summarising and appraising published studies on metal ion concentrations after metal-on-metal total hip arthroplasty
Investigation into the long term systemic health effects of metal released from hip replacement prostheses
Description of metal-on-metal pseudotumour
A radiography website gives a description of a metal -on-metal pseudotumour
National Joint Registry launches its first-ever eBulletin news service
A monthly email delivering news, events and other updates from the NJR and all other relevant healthcare organisations
Metal-on-metal hip implants questions and answers
Metal-on-metal hip Q&A from New Zealand Regulator with links to different hip implant designs at top of page
Metal ions point to metal-on-metal hip failure
A review of Dave Langton's recent (see below) BMJ Open paper on metal ion concentrations
Are elevated blood cobalt (Co) concentrations associated with early failure of metal-on-metal hip resurfacings secondary to adverse reaction to metal debris
Tribology and Total Hip Arthroplasty Implants
Interview with orthopaedic specialist about aspects of tribology of implants
Berwick Review into Patient Safety in the NHS
Recommendations to improve patient safety in the NHS in England
Should we assume medical devices work until proven otherwise?
Blog article by the British Medical Journal
New England Journal of Medicine
Distribution of Industry Payments to Massachusetts Physicians
Medical Device Alert for ADEPT
Medical device recall notice for the DePuy total hip replacement
Finland British Medial Journal Paper examining the number of incidence of Cancer for hip replacement patients
Risk of cancer with metal-on-metal hip replacements: population based study
Article from Professional Engineer, including comments from Tom Joyce on manufacture of medical devices
The DePuy hip replacement recall (text)
Debate session of the Committee on Health and Children of the Oireachtas - Irish National Parliament
The DePuy hip replacement recall (video)
Debate session of the Committee on Health and Children of the Oireachtas - Irish National Parliament
Researchers set safe upper limit metal ion levels for metal-on-metal hip resurfacings
Study from Finland advises safe levels should be set lower than current MHRA advice
Delays and Difficulties in Assessing Metal-on-Metal Hip Implants
New England Journal of Medicine opinion piece on medical device regulation in the USA
FDA panel discusses metal-on-metal hip arthroplasty systems
Blog which provided live coverage of the FDA review as it happened - patient comments stand out
Parliamentary Select Committee on the regulation of implants
British Medical Journal blog summarising problems with medical device regulation
KRO Reporter Netherlands covers metal-on-metal hip failures
Dutch TV documentary about metal-on-metal hip failure that we took part in (in Dutch)
Newsnight feature metal-on-metal hips
UK Newsnight and BMJ TV documentary on metal-on-metal hips which we took part in
Metal-on-Metal Hip Replacement Recall Animation
Clear animation on how metal-on-metal hips are failing, although there are more issues than cup positioning
Medical devices: European Commission calls for immediate action
Press Release from the EC about the move to tighten controls, increase surveillance and restore confidence in medical devices
Calls for enquiry in New Zealand
New Zealand Labour party calls for Select Committee enquiry into faulty hip replacement equipment
Danish Orthopaedic Society advises no more metal-on-metal hip implants in Denmark
How safe are metal-on-metal hip implants?
British Medical Journal raises new concerns over the evidence for failure with metal-on-metal hip implants
Metal on metal hips - patient advice
British Hip Society and British Orthopaedic Association issue advice for patients following news articles about total hip replacement and cancer
Ongoing problems with metal-on-metal hip implants
British Medical Journal article on problems with regulation affecting metal-on-metal hips
British Medical Journal covers the background to the ASR failures
Tom Joyce discusses regulation
Video of Tom Joyce, made as part of the BMJ "Out of Joint" feature
Tony Nargol discusses ASR failures
Video of Tony Nargol, made as part of the BMJ "Out of Joint" feature
Dave Langton discusses engineering analysis
Video of Dave Langton,
ABC’s Four Corners “Joint Reaction”
Australian television programme about metal-on-metal hip failures, much of it from a patient viewpoint
Channel 4’s Dispatches “The Truth About Going Under The Knife”
UK investigative television programme - background details only - broadcast no longer available