Hip resurfacing
James M Simpson, fellow in hip surgery, Richard N Villar, consultant orthopaedic surgeonHip
Metal on metal hip resurfacing is a type of hip replacement or arthroplasty where the head of the femur is preserved and shaped to receive a metal cap or resurfacing. This is distinct from a total hip replacement where the femoral head is excised and the prosthesis sits in the femoral shaft.
Recent results for hip resurfacing in several national joint registries1 2 and the orthopaedic literature3 4 have raised concerns. On 22 April 2010 the Medicines and Healthcare products Regulatory Agency (MHRA) issued a device alert for all metal on metal hip replacements, most of which will be hip resurfacings.5 This, together with reports in the lay press, have raised concerns among patients and healthcare professionals.6 7
Total hip replacement, as distinct from hip resurfacing, is one of the most successful surgical procedures in terms of quality adjusted life years, second only to smoking cessation in terms of cost-benefit analysis using these measures.
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