Canadian caution led to fewer metal hip replacement problems

All-metal hip replacements have led to legions of health problems, along with thousands of surgeries to remove the devices in the U.S. and many countries around the world. But the revision rate in Canada, at least, appears to be quite low.

A new study from the Canadian Institute for Health Information concluded that nearly three of four hip replacements counted in the Canadian joint replacement registry were metal-on-plastic devices, The StarPhoenix reports. Additionally, the study authors found a 5.9% chance that the large-diameter, modular metal-on-metal hip implants would need replacement within 5 years, versus a 2.7% rate for the more typically used metal-on-plastic implants.

The metal hip replacement rate is certainly higher, but it reflects a much lower number than in the U.S. Researchers based their data on almost 60,000 hip replacements done in Canada (excluding Quebec), from 2003 to 2011, according to the story.

Canadian surgeons didn't embrace all-metal hips like their U.S. counterparts did, which accounts for the better numbers, Dr. Michael Dunbar, an orthopedic surgeon and co-chair of the joint replacement registry, told the newspaper.

"It was the right side of the street to be on, for sure," Dunbar is quoted as saying. He noted that all-metal hip implant rates in Canada remained low, even as they surged to almost 45% of all hip implants in the U.S. a few years back. Canada has also tracked hip implants with a voluntary registry, Dunbar noted, which has helped minimize the implants' use even as problems arose.

The FDA is scrutinizing the metal implant products of a number of manufacturers, from Stryker ($STK) to Johnson & Johnson ($JNJ). And J&J alone recalled nearly 100,000 of its DePuy ASR implants after high rates of failure and about 17,000 reports to the FDA of problems. Thousands of patients are now suing J&J and other companies, alleging liability.

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