Aug. 8, 2008
Since its introduction a decade ago, metal-on-metal hip resurfacing has
become increasingly popular because it may conserve femoral bone, increase
functional ability and be easier to revise than other procedures, according to
an article published in the August issue of the Journal of Bone & Joint Surgery.
Michael A. Mont, M.D., of Sinai Hospital of Baltimore, and a colleague reviewed
clinical results – primarily from studies conducted in England, Australia and
Western Europe — and highlighted 10 important lessons learned during the past
The researchers found that metal-on-metal hip resurfacing now accounts for about
10 percent of total hip arthroplasties. Among the lessons they highlight is that
patient selection is the key to success. They cite Australian data on more than
10,000 patients showing that metal-on-metal hip resurfacing is associated with
similar or improved survivorship compared to standard total hip arthroplasty in
men under age 65 but not in men over age 65, and that metal-on-metal hip
resurfacing is associated with a higher risk of short-term failure in men over
age 65 and in all women.
"In the Australian registry, hips that underwent resurfacing as treatment for
osteoarthritis have had better survival than those that underwent resurfacing
for the treatment of developmental dysplasia, inflammatory arthritis and
osteonecrosis," the authors write. "In summary, resurfacing hip arthroplasty has
had a tremendous increase in popularity because of the potential benefits of
femoral bone conservation, possible increased functional ability, and ease of
potential revision procedures. In young men, the survivorship has been similar
to that of standard total hip arthroplasty."
Although none of the authors received outside funding or grants in support of
their research, one or more of them reported that they or their family members
received grants or payments from Wright Medical and DePuy during the past year.