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Published on: September 7, 2022
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Surface replacement of the hip
1Orthopaedic Department, Weston General Hospital; Avon Orthopaedic Centre, Southmead Hospital, Bristol - UK.
Summary
Hip resurfacing has evolved significantly since the 1930s. Modern metal-on-metal designs show promise for specific patient groups, emphasizing implant design and orientation for better outcomes.
Area of Science:
- Orthopedic surgery
- Biomaterials science
- Implant design
Background:
- Hip joint resurfacing attempts began in the 1930s.
- Many early designs failed due to material or fixation issues.
- Metal-on-metal hip resurfacing emerged, but adverse reactions to metal debris became a concern.
Purpose of the Study:
- To review the historical development and challenges of hip resurfacing.
- To identify patient selection criteria for successful metal-on-metal hip resurfacing.
- To highlight the importance of implant design and component orientation.
Main Methods:
- Historical review of hip resurfacing techniques and materials.
- Analysis of failure modes in previous implant designs.
- Evaluation of outcomes and indications for modern metal-on-metal hip resurfacing.
Main Results:
- Numerous hip resurfacing designs failed over the last century.
- Metal-on-metal designs faced challenges due to adverse reactions to debris.
- Current indications are narrower, favoring large, young males.
Conclusions:
- Implant design and component orientation are critical for hip resurfacing survivorship.
- Careful patient selection is essential for successful metal-on-metal hip resurfacing.
- Ongoing research is needed to optimize hip resurfacing technology.
