Évaluation des prothèses totales de hanche à couple de frottement métal-métal

The aim of this report is to reassess the benefit of metal on metal total hip implants included under their brand names on the list of products and services qualifying for reimbursement (LPPR) in order to establish whether their funding by the community is still justified.

The National Committee for the Evaluation of Medical Devices and Health Technologies (CNEDiMTS) recommends: 

- continued reimbursement in the current indications for metal on metal total hip implants with a femoral head of diameter32 mmor less. Long term survival data are awaited.

- no longer to reimburse metal on metal total hip implants with a femoral head of diameter36 mmor greater.

- to continue to reimburse total hip resurfacing implants in a selected population of young active patients with osteoarthritis of the hip whose native femoral head is48 mmor more in diameter. The Committee recommends regulating hip resurfacing arthroplasty in terms of the competency and experience of the implanting surgeon and the level of specialisation of the centres in which the procedure is performed. In addition, further clinical data need to be collected.

For both the metal on metal hip implants with a femoral head diameter of 32 mm or less, and the hip resurfacing implants, the Committee highlights that their benefit depends on their design (design and composition) and that there is a continued need for the Commission to examine specific clinical data on each implant.