Since my last posts the MHRA (Medical and Healthcare Related devices Agency) has issued guidance about the management of patients with painful metal hips. The advice is that patients should have regular follow up to include X Rays and the measurement of blood metal ions. Fortunately we have been doing this for several years here in Southampton, and are lucky to have a reference laboratory for trace element analysis. If you have had a metal hip replacement or resurfacing and wish to discuss any concerns, please get in touch.