Many of our clients wonder if the metal on metal hip still implanted in their body is causing any kind of real harm. They might not feel any pain, or they may just chalk up that persistent ache to the fact that they have a man-made device where their hip used to be. Sometimes a metal-on-metal hip can last a few years before causing the kind of life shattering pain and disability that eventually drives these same patients to our firm and firms like us.
So the question remains – how does a person test for whether their metal-on-metal implant is silently failing in their body? Well, the FDA has recently released a set of guidelines that should help the nervous patient. We recommend that you follow these guidelines even if your metal-on-metal hip implant has not yet been recalled. Of course, we strongly recommend that you follow these guidelines if you do have a recalled implant in your body, though your surgeon should already be closely following your health. We also have our own recommendations based on our experiences with the hundreds of our clients who are still trying to sort through this medical disaster.
The first FDA guideline concerns soft tissue imaging. This kind of imaging will test for “metal artifacts” in the area around your hip. Metal artifacts are bigger than metal ions and can cause serious pain in the tissue around your hip. These metal shavings are usually caused by friction in the metal implant, which generates metal debris. Soft tissue imaging will expose these metal artifacts to the radiologist by creating distortions in the image. This effect is similar to why patients who are having an MRI have to take off their jewelry. Radiologists want a clear image so that they can give you a diagnosis. Luckily, these distortions can actually show the presence of a failing hip. There are three types of imaging that you can have done:
- Magnetic Resonance Imaging (MRI)
- Computed Tomography Scan (CT)
Which one should you have done? We all know that this kind of testing isn’t cheap – so talk to your doctor about which type of test is best for you. Unless your body has problems with an MRI, this is probably the best imaging test that will show the presence of metal debris. Make sure that you don’t just receive a simple MRI, the FDA recommends that you ask for an MRI with MARS, which means “Metal Artifact Reduction.” This type of MRI will make the metal artifacts even easier to see for the radiologist who will study your test when it is done.
A CT scan is also useful, though not as useful for testing the presence of metal artifacts. A CT scan is best for seeing whether your pain is caused by bad implant positioning or the lack of “bony tissue” which may cause your implant to become loose. However, if you have a lot of metal in the area around your hip, a CT scan might be so distorted that the radiologist won’t be able to see it. Ultrasounds are the least useful test for seeing metal in your hip. An ultrasound doesn’t use radiation though, so it may be best for some patients who are being treated for the other illnesses.