Preliminary report of clinical experience with metal-on-highly-crosslinked-polyethylene hip resurfacing.

Objectives: Modern metal-on-metal (MoM) hip resurfacing arthroplasty (HRA), while achieving good results with well-orientated, well-designed components in ideal patients, is contraindicated in women, men with head size under 50 mm, or metal hypersensitivity. These patients currently have no access to the benefits of HRA. Highly crosslinked polyethylene (XLPE) has demonstrated clinical success in total hip arthroplasty (THA) and, when used in HRA, potentially reduces metal ion-related sequelae.

The Effectiveness of Blood Metal Ions in Identifying Patients with Unilateral Birmingham Hip Resurfacing and Corail-Pinnacle Metal-on-Metal Hip Implants at Risk of Adverse Reactions to Metal Debris.

Background: We investigated whether blood metal ions could effectively identify patients with metal-on-metal hip implants with two common designs (Birmingham Hip Resurfacing [BHR] and Corail-Pinnacle) who were at risk of adverse reactions to metal debris.

Methods: This single-center, prospective study involved 598 patients with unilateral hip implants (309 patients with the BHR implant and 289 patients with the Corail-Pinnacle implant) undergoing whole blood metal ion sampling at a mean time of 6.9 years.

Predicting high blood metal ion concentrations following hip resurfacing.

Purpose: To determine whether gender, femoral head size, acetabular inclination, and time since surgery predicted high blood metal ion concentrations following Birmingham Hip Resurfacing (BHR).

Methods: BHR patients with unilateral bearings at one specialist centre with blood cobalt and chromium concentrations measured up to May 2013 were included. This comprised a mixed (at-risk) group including symptomatic patients and asymptomatic individuals with specific clinical and/or radiological findings.

The future role of metal-on-metal hip resurfacing.

Purpose: The purpose of this review was to assess the ten to 15-year outcomes of metal-on-metal hip resurfacing (MoM HR) when performed at designing and independent centres, and make recommendations for the future use of MoM HR.

Methods: Studies reporting ten to 15-year outcomes for modern MoM HR devices from both designing and independent centres were reviewed. Outcomes from these studies were assessed to allow the formulation of recommendations for the future use of MoM HR.

A review of hip resurfacings revised for unexplained pain.

Background: Adverse reaction to metal debris (ARMD) has come to prominence as a mode of failure for metal-on-metal hip resurfacings. These patients frequently present with unexplained groin pain.

Aims: 1) To review all metal-on-metal hip resurfacings revised for unexplained pain seeking evidence for ARMD; 2) To determine the clinical outcome following revision arthroplasty.

A comparison of subsidence of Exeter standard and long stems.

The survivorship of the polished, double taper Exeter stem is related to subsidence within the cement mantle. Long Exeter stems have altered geometry which may influence subsidence characteristics. Using digitised x-rays and appropriate computer software we measured the subsidence of 35 standard and 40 long stem Exeter implants.

The influence of head size and sex on the outcome of Birmingham hip resurfacing.

Background: Hip resurfacing has gained popularity for the treatment of young and active patients who have arthritis. Recent literature has demonstrated an increased rate of revision among female patients as compared with male patients who have undergone hip resurfacing. The aim of the present study was to identify any differences in survival or functional outcome between male and female patients with osteoarthritis who were managed with metal-on-metal hip resurfacing.

Metal-on-metal hip resurfacing in osteonecrosis of the femoral head.

Background: The treatment of end-stage osteonecrosis of the femoral head remains a challenge to the orthopaedic surgeon. Historically, total hip arthroplasty for this condition has been associated with poor rates of survival and function when compared with total hip arthroplasty for the treatment of osteoarthritis. The purpose of this study was to determine the medium-term clinical and radiographic results of metal-on-metal hip resurfacing arthroplasty in patients with end-stage osteonecrosis of the femoral head.