Onderstaand Engels onderzoek laat zien dat het vermeende risico niet is bewezen en dat er nu zelfs bewijzen zijn dat dit risico niet verhoogd is.
Deze gegevens worden gehaald uit een nationale database waarin alle implantaten worden geregistreerd. In Nederland is een dergelijke database sinds kort (eerdere pogingen dit op te zetten mislukten door een gebrek aan financiering en tegenstrijdige belangen) ook in gebruik (LROI) en er wordt nu reeds een dekkingsgraad van 100% behaald: alle implantaten van de heup in Nederland worden hiermee geregistreerd.
Metal-on-Metal Hip Patients are at no greater risk for cancer after 7 years.
NJR research finds metal-on-metal hip replacement patients are at no more risk of developing cancer in seven years following surgery (National Joint Registry) A study commissioned by the National Joint Registry, published online at bmj.com today (British Medical Journal, Wednesday 4 April), confirms that patients who have had a metal-on-metal hip replacement are at no more risk of developing cancer in the first seven years after surgery than the general population.
The authors of the research add that a longer study is required, to monitor incidences for cancers that take many years to develop.
The study was carried out by the NJR statistical support, analysis and research team led by Professor of Orthopaedic Surgery Ashley Blom at the University of Bristol, who said: “The results, using a large representative sample, show that there is no association between metal-on-metal hip replacements and increased incidence of cancer in the first seven years after hip replacement.”
“The data also shows that the incidence of cancer diagnosis is low after hip replacement in general and lower than that predicted for the age and sex matched general population. However comparisons with the general population are not straightforward as hip replacement patients tend to be healthier than others of the same gender and age group.” The study looked at incidence of new diagnoses of cancer for more than 40,000 patients with a metal-on-metal implant and compared them to those with different bearing surfaces (over 245,000 patients) and the general population. The chance of a 60 year-old man with a metal-on-metal hip being diagnosed with cancer in the five years following surgery is 6.2%, compared to 6.7% chance with hip replacement using other bearing surfaces. For women, these figures were 4.0% for metal-on-metal and 4.4% for other bearing surfaces.
Recent coverage on metal-on-metal hip replacements has highlighted concerns about the effect metal ions, from the wear of metal-on-metal implants, have on the body. As yet, there is no proven link between DNA changes and an increased incidence of cancer.
National Joint Registry Lead Elaine Young said: “Each year we commission special topic studies, to accompany the annual reporting process. This time the studies are looking at the metal-on-metal hip replacements and we are pleased to have this second paper published at BMJ online, following the recent stemmed metal-on-metal paper in The Lancet.”
“The National Joint Registry is an extremely valuable source of information based on a mature data set (7 years). We are committed to supporting and enabling further research so that clinicians can use this information to make the best choices for their joint replacement patient. Importantly too, we are sharing more data with patients, to enable them to seek out up-to-date information and advice.”
Notes:
The National Joint Registry (NJR) of England and Wales was established in 2002. Its purpose is to define, improve and maintain the quality of care of individuals receiving hip, knee and ankle joint replacement surgery across the NHS and independent healthcare sector.
Data collection began in April 2003 and the registry now holds over 1.2 million records and more records about certain procedure types than any other registry in the world. As a result of the increasing volume and quality of data it is possible to make accurate analysis available to all stakeholders and contribute significantly to good practice and patient safety.
bmj.com: The risk of cancer in the first seven years after metal-on-metal hip replacement compared with other bearings and the general population: a linkage study between the National Joint Registry of England and Wales and Hospital Episode Statistics
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