Dr. R. Coup Whangarei Hospital

Recent Concerns Prevention Approach to Patient

ASR Recall August 2010 “Voluntary”

British Journal bad results ASR

Already withdrawn in Australia and NZ

Every joint replacement entered in registry. NZ since 1999 Australia 2001

Australian registry

Failure Reaction to metal debris Effects local not systemic

Raised chromium and cobalt levels Soft tissue mass Bone destruction

Most important surgical factor Choice of implant Registry data

General Practice ASR Introduced 2003 Very few in Northland Other designs MoM

Pain continuing after hip replacement Operation note Contact Surgeon Await Clinic Appointment

Infection Peri- prosthetic fracture cRP, X-ray rather than ion levels

Pain persisting No plan 2 nd opinion

Thank you