Evolution in hip resurfacing design and contemporary experience with an uncemented device.

The concepts of surface replacement of the hip and metal-on-metal articulation date back to the 1930s, and recent hip resurfacing designs have been more successful than their predecessors. Experience with the Cormet device followed initial collaboration with Mr. Derek McMinn. Both hybrid implants (a cementless cup and a cemented head) and entirely cementless implants, inserted with use of a variety of surgical approaches, yielded good results, with the cementless option increasing in popularity. The indications for hip resurfacing have become better understood, with the procedure considered most suitable for young and middle-aged males with a high activity profile. In addition, revision surgery, if necessary, has been associated in most cases with bone and soft-tissue conservation. Caution should be exercised when treating small individuals (especially females) and individuals with accompanying diagnoses other than osteoarthritis (such as hip dysplasia), for whom other bone-conserving options may be more appropriate to avoid an adverse reaction to metal debris. Correct implant placement during hip resurfacing is of critical importance.