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A physician must obtain the informed consent of a patient before beginning any procedure, carefully explaining the risks and benefits, and ultimately allowing the patient to decide what to do.  In order to provide the information necessary to obtain informed consent, the physician must stay on top of the medical literature in his or her practice area.  Failing to do so is simply malpractice. 

Important developments in any area of medicine, even  something even as routine and mundane as hip replacement surgery, can occur frequently and, sometimes, without much fanfare.  To be sure, early laboratory tests suggested that metal hips would be more durable than those constructed of other materials, but that does not seem to be the case once they are implanted, and no one really knows why.  Despite ongoing questions about the efficacy of metal hip prostheses, manufacturers continue to make them and surgeons continue to implant them. 

Now, a recent study published in the prestigious British medical journal Lancet leaves little doubt that metal-on-metal hip replacements should not be used because they have to be replaced or fixed more frequently than implants made of other materials.  One of the authors of the study was quoted saying that if she were a patient, she would not choose a metal-on-metal hip.  In addition to needing to be replaced about 300% more often than ceramic or plastic joints in the first five years, metal hips also may leach dangerous metals into a patient’s body.

While metal hips are now only used about 5% of time, one might ask why they still are used at all.  U.S. manufacturers have been asked to perform safety studies to study effects for the benefit of both current and future users, but their use has not been banned.  Perhaps this new study will make a difference.  Until then, when a patient elects to have a metal hip implanted, a physician willing to use that material better clearly and effectively explain the risks and obtain informed consent from the patient before performing the procedure to avoid future liability and a medical malpractice lawsuit.

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