Metal-on-metal resurfacing arthroplasty: no way under the sun!--in opposition

The functional demands and the longevity of hip arthroplasty patients are increasing. High volumetric wear and osteolysis limit the durability of metal-ultra high molecular weight polyethylene resurfacing. Cemented femoral hemiresurfacing components (no acetabular component) do not develop osteolysis and rarely loosen. Consistent long-term fixation has been demonstrated with hemispherical cementless acetabular components. Metal-metal bearings have demonstrated low wear and rare osteolysis over 3 decades of use. These facts form foundation for total hip resurfacing with metal-metal bearings.