The evolution of hip resurfacing arthroplasty.

Metal-on-metal hip resurfacing, a significant recent development in hip arthroplasty, preserves proximal femoral bone stock, optimizes 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 renaissance of metal-on-metal articulations for total hip arthroplasty has enabled the introduction of new hip resurfacings, and many implant manufacturers have introduced such systems. Early results are encouraging, and complications commonly seen in the 1970s and 1980s, such as early implant loosening and femoral neck fracture, are rare. Background research and better understanding of implant failure suggest that current hip resurfacing technology has developed beyond that of an experimental procedure.