NICE Wants Longer Lasting Hips

The Brits, who first raised warnings about metal-on-metal hips, have issued a new draft guidance with stricter benchmarks for quality.

The National Institute for Health and Care Excellence (NICE) issued the draft guidance on October 18, 2013. The guidance recommends that a new hip should work well in at least 95% of cases over 10 years.

NICE’s Professor Carole Longson commented, “Importantly, as we now have more information about how long artificial joints can last, we have recommended the use of prostheses with a proven lower revision rate. This means that a new joint should work well in at least 95% of cases over 10 years, so a revision may be needed in 5% or fewer cases over this period. Our existing guidance advises that prostheses should work well in at least 90% of cases, so repeat surgery may be needed in up to 10% of cases over 10 years.”

England’s Department of Health asked NICE to produce guidance on using total hip replacement and resurfacing arthroplasty in the National Health Service in England and Wales. The Appraisal Committee considered the evidence submitted and the views of non-manufacturer consultees and commentators, and clinical specialists and patient experts.

The guidance document was prepared for consultation with the consultees. It summarizes the evidence and views that have been considered, and sets out the draft recommendations made by the Committee. NICE invites comments from the consultees and commentators and the public for this appraisal. The document should be read along with the evaluation report.

The Appraisal Committee is interested in receiving comments on the following:

• Has all of the relevant evidence been taken into account?
• Are the summaries of clinical and cost effectiveness reasonable interpretations of the evidence?
• Are the provisional recommendations sound and a suitable basis for guidance to the NHS?
• Are there any aspects of the recommendations that need particular consideration to ensure avoiding unlawful discrimination against any group of people on the grounds of race, gender, disability, religion or belief, sexual orientation, age, gender reassignment, pregnancy and maternity?

The closing date for comments is November 8, 2013. The second Appraisal Committee is scheduled to meet on November 20, 2013. A final guidance is expected to be issued in February, 2014.

To comment, click here.