Metal-on-Metal Hip Prostheses - Coursework Example

EVIDENCES OF METAL-ON-METAL HIP PROTHESSES 2005 By Student’s Name Code course name Professor’s name University name City, State Date Introduction A human body comprises of the blood, flesh and bones. These things together work well and normally the body functions without any complications until there comes some disorders in among these three components (Lombardi et al. 2004). In the absence of any abnormality in the blood may it be deficiency, the blood can easily be dealt with since the victim’s blood group is tested and a donor and a donor searched with the same blood group and donates the blood either for free or at a pay (Brodner et al. 2003). In the cases of any complications in the flesh, the part of the body that the flesh has the problem is just fixed with flesh from other part of the body or flesh from other individuals is applied in the person’s place of discomfort and since flesh is elastic it fits in the place or the part of the body that it has been inserted (Lhotka et al., 2003). Still in the cases of flesh, if the part of the body that the flesh has the complications is not so crucial, the wound is just left to heal and the individual gets on well with their day to day activities without difficulties (Brodner et al. 2003). Bones are the most crucial components in the human body. Bones determines the posture of the human body; they are the ones that give support to the flesh, also the blood. Bones have to be functioning in the proper manner at any given time. Bones are very hard and they don’t incur wound or deficiency as in the cases of flesh and blood respectively. Bones break. In the case of bone breaking the individual cannot function in any way. The bone breaking or dislocation needs to be dealt with a lot of care (Ladon et al. 2004). Bones needs to be in full normality for the human body to function well and in case of any breaking or dislocation they need to be treated with much care. If the bones cannot heal and recover to its normal functioning, the part of the bone affected can be replaced with a metal or something hard as the bone. Much of the bone infections are breaking and dislocation (Lombardi et al. 2004). Breaking comes in the normal lining of the bone but the dislocations is in the joints like the shoulder, wrist, knee, ankle joint etc. in the cases of dislocation in these areas which in many cases is untreatable, it can be replaced with a metal. This papers aim is to discuss the effective and safety evidences of the metal implants on the hip joint that was conducted in Singapore in the year 2005. This experiment is commonly known as the metal-on-metal hip prostheses in 2005 (Treacy et al. 2005). Metal-on-metal Hip implant is the process by which the natural hip of the human being is being replaced by an artificially designed metal hip. These happens after the natural one is damaged in such a way it cannot be treated or the individual may feel it is necessary for him/her to operate with a metal one due to the safety of it in issues regarding breaking or dislocation (Lombardi et al., 2004). In these case both the socket and ball consists of metal, the ions that protects the metal from reacting with the flesh. At the ball joint, there is the polythene paper and plastic coatings that prevents the metals from grinding each other. These metal grafts are important because they are used in hip replacement operations and procedures of hip resurfacing. This implant, are normally used because they reduce hitches of residues wear (Lhotka et al. 2003). Hip dislocation causes a lot of pain and difficulties in walking, therefore many individuals prefer using the metal way in order to sideline themselves with the consequences that occur upon the dysfunctional. Another reason that can lead to metal-on-metal hip replacement is when patients’ symptoms do not respond to treatments such as physical therapy medication and exercise (Lhotka et al. 2003). If the symptoms of the patient persist, an orthopedist may advise ancient hip resurfacing surgery or hip replacement. This is enough evidence that this process if safe that even the orthopedists recommend for it. Metal hip context is most preferably for the middle aged and old people whose bones and joints have attained the peak growth. This is because the metal kind of the hip needs an individual whose bones are developing no more (Manning et al. 2005). Evidences on the safety of metal-on-metal hip implant. The evidences on the safety of the metal-on-metal processes have been justified by various researches upon where the process is undertaken. This research side includes hospitals and the orthopedics research centers. For instance in United States of America and in Australia who are the main researchers and providers of these devices indicates that most actually about 90% of the individuals who undergoes these processes and surgeries do not go back to the hospital with the same complications (Ladon et al. 2004). The orthopedics body dealing with the registry of the individuals whose have acquired these devices in their bodies in the United Kingdom where they register these individuals basing on their age, body size and gender and also shown lower revision rates in the patients. These researches also shows that an average of 85% of the individuals in the UK do not go for revisions within the period of seven years. This is also the case in Australia where more than 90% of the people with these implant do not go for the revision of the same between the span of seven years (Lombardi et al. 2004). The safety measures and evidences from the manufacturer of the devices shows that people who buy these gadgets are much satisfied with the services derived from them. Corin USA Limited and the Smith and Nephew, Inc. companies indicates that the complaints they receive from their clients are less than 10% of the overall number of customers they serve within a span of ten years (Ladon et al. 2004). Interviewed customers and user of the metal hip devices justifies that this programme is good and that since their adoption of the idea, they have not regretted. Mac smith an Australian businessman who incurred a hip dislocation when he was at the age of thirty three years as a result of an accident involving his motorbike while driving from work. He states that upon searching for a solution which would see his hip deformities treated (Ladon et al., 2004). He says that he went to one of the leading hospitals in Australia with matters related to orthopedics and that is when one of the doctors advised him on the metal hip implantation. Though the whole process was expensive that it made him felt the financial effect, the implant has helped him since he became well and has since recovered all the resources he used and the ones he missed to achieve when he was undergoing the treatment (Treacy et al. 2005). He say on the health issues, it does not affect his health and he does not see much disadvantage in it, he stated that his body has not lost any of its natural appearances and that his feeding and dietary issues has been well and no changes on his body size. Smith says he has not heard any threats in the hips functions (Lhotka et al. 2003). He says the metal does not affect the flesh of his body since they are designed and coated with ions that prevent it from reacting with the body flesh. This is also the case with David Trevor a Canadian forester who went abroad in the United Kingdom to seek these crucial services where he states that even the changing weather conditions in the Canadian context does not affect or change the temperature of this metal. His wife says that they even don’t remember that he had an operation and only thinks of them when someone mentions those (Lombardi et al. 2004). There are some of regulatory agencies that have come up to give advice and directions alerting the metal-on-metal implants on the following safety issues which are; Around 2010 April, the Healthcare products Regulatory Agency and the Medicines of the united kingdom advised on the medical device alert that had precise follow-up recommendations for patients of this kind of replacement (Ladon et al. 2004). Some of the recommendations were issues like imaging for patients and the blood test. In 2012 Australia, a therapeutic Goods Administration published safety information for the healthcare professionals. In Canada 2012, Health published a public health communication to patients regarding metal-on-metal hip implants and the orthopedic surgeons. The efficacies of the metal-on-metal hip implant. The metal on metal hip implant has several efficacies as shown below in this essay. It has been considered to be more efficient than other transplant and replacement of joints. Its durability period is higher and once performed the patient can be assured that the issue has been solved. The advantage of this metal on metal is that once done, there is no urgency in its replacement. In its place there is no need to put on another in its place and by this there are a lot of resources which are fully utilized and they include time and manpower (Lhotka et al. 2003). Once it has been carried out the casualty is free from taking another procedure .Which cost a lot of money to perform and also impacts on the health of the individuals negatively. It has been greatly being preferred since its being perceived as cost effective and economical hence best option due to its durability. The metal on metal hip implant has been considered to provide a high survivorship implant than other implants (Lombardi et al. 2004). The other benefits associated with metal to metal hip replacement is that it has been found that larger head size metal to metal hip replacement decreases the risk of dislocation which is the main weakness associated with the hip replacement. This attributes makes the metal to metal hip implant sensible since it is not prone to dislocation like other hip replacement. This has led to many people opting for it rather than other option available (Lhotka et al. 2003). Hip implants are a medical component which aims at restoring the movement and reduce pain that is normally caused by diseases such as arthritis and some other injuries or hip diseases .In every hip implant operation; there are some unique risk and benefit associated with it. The system is unique because the characteristic and dimension of each implant is dictated by various factors which include; material, size, and weight. In each patient, hip implant system normally have a different result (Lombardi et al. 2004). The duration of the device is normally influenced by various factors which are as follows; sex, weight, diagnosis, age, activity level, the kind of implant to be undertaken and the surgery conditions. The following are some of the hip replacement devices with distinguished bearing surfaces that are available and include; ceramic -on- polythene in this case the socket is made up of plastic lining and the ball is normally made up of ceramic, the other alternative is the metal on polythene; the socket is made of plastic and the ball is made up of metal (Lhotka et al. 2003). The other is ceramic on ceramic in this case the ball is made up of ceramic and the socket to be made up ceramic lining. Ceramic-on-metal, in this case the ball is normally made up of ceramic while the socket is normally made up of metal lining. The last case which is our topic of discussion is the metal-on-metal whereby the ball and the socket are normally made up of metal. An evaluation carried on some patients in Europe shows that a significant number of patients are normally implanted with metal-on metal (Naudie 2004). A metal-on-metal hip implant system is composed of shell, stem and the ball. All of these are made of metal materials. This kind of hip implant was meant to offer patient with the following assistances; there is reduction of chances of failure of device, there is less wear and tear of the device material where the socket and the ball rub on one another and lastly there is reduction of chances of dislocation in occasion whereby the ball of the femur slides or get out of its socket in the pelvis (Lhotka et al. 2003). There are two major metal-on metal hip implants which are namely; Traditional total hip replacement systems and Resurfacing hip systems (Naudie 2004). The traditional Metal-on-Metal system is composed of a metal femoral, stem metal ball, the metal hip bone and also the thighbone. This is clearly shown in the diagram below. (Treacy 2005) (Treacy 2005) (Treacy 2005) In the diagram above, the multiple well-matched components have to be identified. The metal-on-Metal Resurfacing system is composed of trimmed with some femoral head crowned with a covering composed of metal. In case of any damaged cartilage and bone in the socket are usually removed and immediately replaced with a metal acebabular component (Naudie 2004). (Treacy 2005) It was through a pre-market approval program that this system was approved. For each application, there was an intensive demonstration of the effectiveness and safety of this system by the manufactures (Lhotka et al. 2003). There are some problems that are normally associated with metal-on-metal hip implants. It has got some risks that are unique, in addition to the hip implants general risk. During walking or running, the metal cup and the metal ball slide against each other causing friction. Besides the metal can be released from some parts of the implant from two implants are intertwined (Naudie 2004). These metal releases where the implant are intertwined will lead to wear and tear of the device surrounding the implant that mat result to serious damage to the soft tissues around the joint and the implant and also to the bone. This scenario is normally referred to as (ARMD) which is abbreviation of adverse reaction to metal debris or some may call it (ARTL) which means adverse local tissues reaction. It may result to severe pain, device failure, loosening of implant and hence a need arises for surgical revision due to damage of that soft tissue around the position the implant takes place. By this the health of the individual is put to danger and a lot of resources are put to place (Naudie 2004). There will be release of metal ions which when they enter in the blood stream of the individual hence circulates in other parts of the body affecting the delicate tissues such as the heart. This may lead to complications such as systemic reactions and even death. Conclusion Considering the safety and efficacies evidences discussed above, there are risks associated with metal-to-metal hip implant. However, it helps in case of any complications in the hip dislocations or the breaking of the hip bones. Due to the risks involved, more orthopedics should be trained and the technology behind the hip transplant being introduced all over the world including the developing ones instead of only concentrating on the developed countries. References Amstutz, H. C., 2003, Metal on metal hip prostheses: past performance and future directions. Philadelphia: Lippincott-Raven. Brodner W, Bitzan P, Meisinger V, Kaider A, Gottsauner WF, Kotz R., 2003, Serum cobalt levels after metal-on-metal total hip arthroplasty. The Journal of bone and joint surgery American volume, 85-A:2168-2173. Lombardi AV, Mallory TH, Cuckler JM, Williams J, Berend KR & Smith TM., 2004, Midterm results of a polyethylene-free metal-on-metal articulation. The Journal of arthroplasty, 19:42-47. Lhotka C, Szekeres T, Steffan I, Zhuber K, Zweymuller K., 2003, Four-year study of cobalt and chromium blood levels in patients managed with two different metal-on-metal total hip replacements. J Orthop Res, 21(2):189-195. Ladon D, Doherty A, Newson R, Turner J, Bhamra M, Case CP., 2004, Changes in metal levels and chromosome aberrations in the peripheral blood of patients after metal-on metal hip arthroplasty. J Arthroplasty, 19(3):78-83. Manning DW, Chiang PP, Martell JM, et al., 2005, In vivo comparative wear study of traditional and highly cross- linked polyethylene in total hip arthroplasty. J Arthroplasty, 20:880 Naudie D, Roeder CP, Parvizi J, Berry DJ, Eggli S, Busato A., 2004, Metal-on-metal versus metal-on-polyethylene bearings in total hip arthroplasty: a matched case control study. J Arthroplasty, 19(7 Suppl 2):35-41. Treacy RB, McBryde CW, Pynsent PB., 2005,Birmingham hip resurfacing arthroplasty. A minimum follow-up of five years. J Bone Joint Surg Br, 87:167. Willert HG, Buchhorn GH, Fayyazi A, et al., 2005, Metal-on-metal bearings and hypersensitivity in patients with artificial hip joints. A clinical and histomorphological study. J Bone Joint Surg Am, 87:28. Read More