4.2 Article

From embodiment to evidence: The harmful intersection of poor regulation of medical implants and obstructed narratives in embodied experiences of failed metal-on-metal hips

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HEALTH
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SAGE PUBLICATIONS LTD
DOI: 10.1177/13634593231179026

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implant failure; medical device regulation; metal-on-metal hips; orthopaedic surgery; patient narratives

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This research presents the findings of a study on patients with failed metal-on-metal hip implants, exploring the intersection of poor regulation with patients' narratives of pain and the denial of their experiences and restoration. By obstructing patient narratives, the regulatory system undermines the evidence needed for effective operation. Patient narratives serve as the basis for scientific evidence of widespread implant failure.
This research presents the results of a study about people with failed metal-on-metal hip implants, and draws on the STS concept of the technological imperative alongside research on the value of patient knowledge in clinical settings and the legitimacy of embodied stories. Popularly understood as positive and life changing, hip replacement surgery was hailed as 'the operation of the century', until a series of widespread failures of hundreds of thousands of hip implants, known collectively as metal-on-metal (MoM) hips, drew attention to the poor regulation of medical implants. This paper argues that poor regulation intersects with narratives of patients' pain, which are obstructed by surgeons and the UK regulatory body, with the effect of denying both patients' embodied experiences of implant failure, and their restitution to good health. Patient narratives about problems with their hip implant are the wellspring from which scientific evidence emerges which can indicate widespread implant failure. By obstructing these narratives the regulatory system undermines the very evidence it needs to operate effectively.

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