Outcomes after revision of metal-on-metal hip resurfacing arthroplasty

We report the results of 58 hip resurfacing arthroplasties (HRA) revised by a single surgeon with an average of 5.2±2.6 years follow-up. The four most common causes for revision were acetabular component loosening, femoral neck fracture, femoral component loosening, and adverse wear related failure (AWRF). In 95% of cases (55/58), the revision bearing was a large metal-on-metal type including all seven AWRF cases; three cases were revised to ceramic-on-polyethylene. There were two repeat revisions due to acetabular component loosening. Revision of AWRF had an excellent outcome using limited debridement and a stable large metal bearing placed in the correct position. The only problematic group was the one revised for acetabular loosening in which 2/16 (6%) required repeat revision for failure of acetabular fixation.