Canadian academic experience with metal-on-metal hip resurfacing

The current depth and breadth of experience in hip resurfacing in Canadian academic centers is not well known. This study endeavors to increase awareness of the prevalence of programs and current experience in a select number of representative teaching centers by examining the learning curve of high-volume surgeons. A questionnaire was sent to all academic centers in Canada to identify the volume of hip resurfacing, surgical approach, and type of prosthesis. In addition, five surgeons, not fellowship-trained in hip resurfacing, were selected for a detailed review of their first 50 cases, including survey of patient demographics, surgical approach, radiographic evaluation, complications, and revision. Eleven of 14 academic centers are currently performing hip resurfacing. All of these centers had performed more than 50 cases, with 10 of 11 of them having more than one surgeon performing the procedure. The posterior approach was found to be the most commonly utilized in surgeries. The overall revision rate was 3.2% at a mean time of 2 years, with femoral neck fracture (1.6%) being the most common cause for failure. The failure rate was comparable to other centers of expertise and lower than previously published multicenter trials. All surgeons reviewed were in specialized arthroplasty practices, which may contribute to the relatively low complication rates reported.