Metal-on-Metal Hip Resurfac...

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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 10 years.

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.