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Total hip resurfacing: a viable alternative to total hip arthroplasty for the young active hip patient in the United States?

Macaulay, William

doi: 10.1097/BCO.0b013e3282f533c5
SPECIAL FOCUS: Hip Reconstruction

Purpose of review Metal-on-metal hip resurfacing was approved by the Food and Drug Administration in the United States in May 2006. The present review provides a succinct overview of metal-on-metal hip resurfacing for the reader who may wonder whether this procedure currently has a role in the treatment of hip disease in the young active American adult.

Recent findings Recent studies reviewed herein focus on the issues of head viability, biomechanics, metal ions and bone preservation. Also, although late mid-term and long-term outcomes data are lacking, published short-term to mid-term survivorship is highlighted.

Summary Metal-on-metal hip resurfacing is an interesting improvement/modification of traditional hip resurfacing systems that has fallen out of widespread use due to unacceptably high rates of failure. Despite the fervor demonstrated by aggressive patients searching for a more bone-preserving alternative to total hip arthroplasty, metal-on-metal hip resurfacing should be reserved for appropriately selected patients and should be performed only by skilled/high-volume/properly trained hip surgeons. It is incumbent upon surgeons and implant manufacturers to monitor early complications and to closely track and report outcomes over the mid-term and longer term to assure patient safety now and into the future.

Center for Hip and Knee Replacement, Department of Orthopedic Surgery, Columbia University, New York, New York, USA

Correspondence to William Macaulay, MD, Professor of Clinical Orthopedic Surgery, Director, Center for Hip and Knee Replacement, New York Presbyterian Hospital at Columbia University, 622 W 168th St, PH 1146, New York, NY 10032, USA Tel: +1 212 305 6959; fax: +1 212 305 4024; e-mail:

© 2008 Lippincott Williams & Wilkins, Inc.