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

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.