Metal Resurfacing of Hips
There remains concerns in the press and scientific literature about metal on metal total hip joint replacement bearing surfaces. Hip replacements/ hip resurfacing with metal-on-metal hip bearings became very popular in the late 1990’s and early 2000’s with implant companies, the popular press, patients and some surgeons being a driving force. In the late 2000’s, however, it became apparent there was a much higher failure rate (5-6x that of standard hip replacements in some patient groups) with these bearing surfaces. There were also incidences of significant soft tissue damage being caused by metal wear debris, so called pseudo-tumours. NHSScotland is aware of these concerns and takes patient safety seriously. There are currently no total hip joint replacements using metal on metal bearings being performed in NHSScotland. Hip resurfacing procedures are not routinely offered in the majority of health boards in Scotland and there are only a small number of specialist centres performing the procedure under close follow up. However, there may be a limited place for metal resurfacings procedures. The belief that it is easier to revise a hip resurfacing than a hip replacement is misplaced.
This note sets
out NHSScotland position with regard to hip resurfacing with metal
have the option to consider a range of choices to improve their quality of life
when they have significant pain or lack of mobility due to damage to a hip
The group of
patients to whom a metal hip resurfacing procedure is a potential
option tend to be male, young, with good bone quality and with large
There must be
additional informed and recorded consent agreed with the patient that currently
a resurfacing procedure does involve the use of a metal bearing and that there
may be a risk of early failure and soft tissue damage due to metallosis.
The patient must agree, and the surgeon must ensure that more intensive
follow-up is in place than is routine following standard total hip replacement
surgery so any development of metallosis will be found early and managed
properly in line with current guidelines for metal hip bearings from the MHRA.
This follow up may involve yearly review and x-rays together with blood tests
to monitor metal levels that can become elevated.
must have significant experience in hip resurfacing procedures, record specific
consent for the procedure and ensure follow up according to MHRA guidance
The device chosen must be one with a minimum 10A Orthopaedic Data Evaluation Panel (ODEP) rating Bor be part of a registered research trial.
Patients and surgeons should ensure that the advice from the British Orthopaedic Association and British Hip Society is followed.
Mr Edward Dunstan
Consultant Orthopaedic Surgeon
Chair – Scottish Committee for Orthopaedics & Trauma
The Winter SCOT Meeting will take place on 1 & 2 February 2019 in Crieff Hydro Hotel.
The Final Programme is now available.
A quick reminder of the dates of the Summer SCOT Meeting:
Date: Friday 7 September 2018
Location: Dunblane Hydro Hotel
Draft Programme: Download
The STOTS (Trainee) Day will take place on Thursday 6 September 2018 with a dinner in the evening.
STOTS Main Sponsor:
SCOT Meeting Sponsors:
Other Educational Support:
Date: Friday 2/2/2018 to Saturday 3/2/2018
Venue: Crieff Hydro Hotel
Major Sponsors :
Sponsorship Statement: All companies have paid only to exhibit at this meeting and have had no other involvement in the organisation of the meeting, including the choices of speakers or agenda items.
Dunblane Hydro Hotel
Friday 8 September 2017
Download Draft Programme
Register to attend (attendance limited to Scottish Orthopaedic Consultants & Trainees)
The Summer SCOT Meeting takes place on Friday 8/9/2017 at Dunblane Hydro. The Guest Lecture is by Rhidian Morgan-Jones on the subject of “The Infected Knee Replacement”. There will be updates from the Scottish Arthroplasty Project, along with Registrar free papers.
We are grateful to the following sponsors:
An updated programme is available for the Winter SCOT Meeting – 3 to 4 February at Crieff Hydro. Mr Brenkel is arranging accommodation – if you have any questions, please contact him directly.
SCOT now has presence on both Facebook and Twitter – please follow us via these channels to ensure you remain up to date!
Abstracts are invited for the Winter SCOT Meeting from Scottish Orthopaedic Trainees. Normally approximately 15 papers are accepted and the presenters will be sponsored to attend the whole Meeting. Those not selected may attend the Meeting on the Friday and Saturday if they wish, but will not be able to stay overnight.
Abstracts should be structured as per the instructions below and should not exceed 250 words. Please ensure you submit your abstracts by Friday 21st October 2016to Kimberley Moore Ede, Secretary to Professor Simpson.
Date: 3-4 February 2017
Location: Crieff Hydro Hotel (PH7 3LQ)
Contact: Ivan Brenkel
Friday 3rd Feb 2017
9.30am-12 noon Business meeting EARN ROOM
12 noon -1pm Trauma working group EARN ROOM
10am-1pm Shoulder meeting BARVICK ROOM
12 Noon-1.30pm Registration and Lunch
1.30-3.30pm Spr presentations. DRAWING ROOM
4.00pm Tim Wilton: President BOA. Topic TBA
4.35 pm Mr J Reid: Consultant Orthopaedic Surgeon Edinburgh: Experience of being a training director
5.10 pm Steven Cooke: Consultant Paediatric Orthopaedic Surgeon
University Hospitals Coventry & Warwickshire NHS Trust: Surgical training
6.00.pm End of session
Saturday 4th February 2017 DRAWING ROOM
9.30am Andrew Murray: Sports and Physical Activity Doctor/ GP/ Runner. Topic TBA
10.00am Kapil Kumar: Consultant Orthopaedic Surgeon Aberdeen: Shoulder Arthroplasty, its evolution.
11.00am Stephen Cooke: Consultant Paediatric Orthopaedic Surgeon
University Hospitals Coventry & Warwickshire NHS Trust. Paediatric Elbow Injuries
11.30am Mr Martin Sarungi: Consultant Orthopaedic Surgeon Golden Jubilee Hospital. Topic TBA
12.00pm Buffet Lunch and Depart.
This meeting is mainly supported by an unrestricted educational grant from Depuy, Arthrex, styker and Zimmer which funded the educational sessions and lecturers expenses only. All companies have paid only to exhibit at this meeting and have had no other involvement in the organization, including the choices of speakers or agenda items
The Innaugural STOTS Meeting and Dinner took place on 1 September 2016 at Dunblane Hydro Hotel. It was attended by 60 trainees from throughout Scotland (more than double what was expected). STOTS Programme 2016.
In future it is planned to expand this to recognise the significant achievement of ST8 trainees completing their rotations, along with the award of the “Silver Sgian Dubh” to the Scottish Trainer of the Year.