NHS Implant Analysis Service

In recent years, surgery has benefited from technological breakthroughs with the introduction of successive devices and procedures showing improved outcomes. Over time some of these innovative theoretical breakthroughs have had questionable durability in humans and some have led to catastrophic failure such as some metal on metal hip replacements and breast implants.

Baroness Cumberlege report in 2020 stated “The system is not good enough at spotting trends in practice and outcomes that give rise to safety concerns…….. Innovation in medical care has done wonderful things and saved many lives. But innovation without comprehensive pre-market testing and post-marketing surveillance and long-term monitoring of outcomes is, quite simply, dangerous. Crucial opportunities are lost to learn about what works well, what does not, what needs special measures put around its use, and what should be withdrawn because the risks over time outweigh the benefits.“
(First Do No Harm. The report of the Independent Medicines and Medical Devices Safety Review Shared by Baroness Cumberlege Crown copyright 2020)

The UK has an enviable track record of clinical research and follow up in joint replacements. Much of this data, whilst very useful, does not include detailed physical analysis of the device performance. This service addresses the need for physical analysis and reporting whilst providing a robust, speedy service providing surgeons with an implant performance on devices removed from the human body, irrespective of the reasons for initial revision. The purpose is to provide assessment on all devices, whether the performance was as well as anticipated or not.

“ …when that implant comes out, you as the surgeon are holding in your hand a wealth of information; clues about what went wrong, why it failed and how that might have been prevented.”

Rowena Dean, Care Group Director for Collaborative Care, North Tees and Hartlepool NHS Foundation Trust