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Over one-million patients worldwide have received metal-on-metal (MoM) hip arthroplasties with a significant proportion requiring revision surgery in the short-term for adverse reaction to metal debris (ARMD). Worldwide authorities have subsequently issued follow-up guidance for MoM hip patients. This article compares follow-up guidelines for MoM hips published by five worldwide authorities, analyses these protocols in relation to published evidence, and assesses the financial implications of these guidelines. A number of major differences exist between authorities regarding patient follow-up, with vast cost differences between protocols (£84 to £988/patient/year for stemmed MoM hips and £0 to £988/patient/year for hip resurfacing). Current worldwide guidance is neither evidence-based nor financially sustainable with most protocols lacking the sensitivity to detect asymptomatic ARMD lesions.

Original publication

DOI

10.1016/j.arth.2015.03.009

Type

Journal article

Journal

J Arthroplasty

Publication Date

08/2015

Volume

30

Pages

1317 - 1323

Keywords

finance, follow-up, guidelines, hip resurfacing, metal-on-metal, total hip arthroplasty, Arthroplasty, Replacement, Hip, Continuity of Patient Care, Cost-Benefit Analysis, Device Removal, Hip Prosthesis, Humans, Internationality, Metal-on-Metal Joint Prostheses, Practice Guidelines as Topic, Prosthesis Failure, Reoperation