Resurfacing arthroplasty of the hip

Hip resurfacing is an attractive concept as it preserves proximal femoral bone stock, optimises stress transfer to the proximal femur and offers inherent stability and optimal range of movement. The results of hip resurfacing in the 1970s and 1980s were disappointing and the procedure was largely abandoned by the mid-1980s. The expectation that these prostheses would be easy to revise was not often fulfilled. The large diameter of the articulation combined with thin polyethylene cups or liners, led to accelerated wear and the production of large volumes of biologically active particulate debris, leading to osteolysis and implant loosening. The renaissance of modern metal-on-metal articulations for total hip arthroplasty enabled the introduction of a new generation of hip resurfacings and the majority of the main implant manufacturers have already introduced such systems. Early results are encouraging and complications commonly seen in the 1970s and 1980s, such as early implant loosening and femora( neck fracture, now appear to be rare. (C) 2005 Elsevier Ltd. All rights reserved.