Modern Metal-on-Metal Hip Resurfacing: Important Observations from the First Ten Years

Total hip resurfacing, in which a cementless acetabular component is combined with a metal-on-metal (cobalt-chromium alloy) bearing, was introduced approximately ten years ago. Previous resurfacing devices had failed because of insufficient initial fixation or as a result of progressive inflammatory bone resorption (osteolysis) due to high volumetric wear of the large-diameter acetabular bearing, which is composed of conventional polyethylene1,2. Extensive pelvic bone loss often made for a challenging revision.