Given the recent reports of high failure rates, an improved understanding of the mechanism of failure of large diameter metal-on-metal hip arthroplasties is essential. We present clinical data and tribological analysis of a consecutive series of 74 failed large diameter metal-on-metal hips, comparing the Durom (Zimmer) with the Birmingham hip resurfacing (BHR) (Smith and Nephew). We retrospecti...

OBJECTIVE To determine whether elevated blood cobalt (Co) concentrations are associated with early failure of metal-on-metal (MoM) hip resurfacings secondary to adverse reaction to metal debris (ARMD). DESIGN Cohort study. SETTING Single centre orthopaedic unit. PARTICIPANTS Following the identification of complications potentially related to metal wear debris, a blood metal ion screening...

Revision of metal-on-metal (MoM) total hip arthroplasty (THA) or hip resurfacing is associated with high complication rates. The authors propose dual-mobility components as a surgical option and present short- to mid-term results of MoM hips revised with dual-mobility components. Eighteen consecutive hips that underwent revision of MoM THA or hip resurfacing using dual-mobility components were ...

Bone surface strains were measured in cadaver femora during loading prior to and after resurfacing of the hip and total hip replacement using an uncemented, tapered femoral component. In vitro loading simulated the single-leg stance phase during walking. Strains were measured on the medial and the lateral sides of the proximal aspect and the mid-diaphysis of the femur. Bone surface strains foll...

It is standard practice in many institutions to routinely perform preoperative and postoperative haemoglobin level testing in association with hip joint arthroplasty procedures. It is our observation, however, that blood transfusion after uncomplicated primary hip arthroplasty in healthy patients is uncommon and that the decision to proceed with blood transfusion is typically made on clinical g...

1. SA Brennan, JA Harty, C Gormley, SK O’Rourke. Comparison of acetabular reamings during hip resurfacing versus uncemented total hip arthoplasty. J Orthop Surg (Hong Kong) 2009;17:42–6. To the Editor: We read with interest the article by Brennan et al.1 They concluded that: “In hip resurfacing, the use of an appropriately small femoral component avoids oversizing the acetabular component and r...

OBJECTIVE To report on the relative cost-effectiveness of total hip arthroplasty and resurfacing arthroplasty (replacement of articular surface of femoral head only) in patients with severe arthritis suitable for hip joint resurfacing arthroplasty. DESIGN Cost-effectiveness analysis on an intention-to-treat basis of a single-centre, single-blind randomised controlled trial of 126 adult patien...

Hip resurfacing arthroplasty is a type of hip replacement that involves capping the femoral head and preserving bone of the proximal femur. Metal-on-metal surface replacements have been manufactured since the early 1990s. Recent studies indicate excellent clinical results with low failure rates at 1- to 5-year follow-up. Although these early results are encouraging, resurfacing devices must be ...

A systematic review and meta-analysis of trials comparing hip resurfacing to metal-on-metal total hip arthroplasty was conducted to determine if there is a difference in serum metal ion levels in patients receiving these implants. EMBASE and MEDLINE databases were searched from inception to December 2010 for all trials involving the use of these devices. Eligibility for inclusion in the review ...