ABSTRACT

Hip resurfacing has been an attractive alternative to total hip replacement as it involves less bone resection and reduced risk of dislocation, with an excellent quality of life in a young, active individual with hip arthritis. Sir John Charnley developed Teflon-on-Teflon resurfacing in the 1950s, which was associated with a high failure rate due to poor wear characteristics. A Canadian Arthroplasty Society report found that the female sex is an independent risk factor for loosening and early failure. In 2010, the articular surface replacement was recalled because of high rates of early failure secondary to poor acetabular design, which resulted in an unacceptably low clearance, cup deflection and increased wear. Recurrence of adverse reactions to metal debris (ARMD) and dislocation are the two most common complications with revision surgery for failed resurfacing. Surgeons must ensure the entire ARMD lesion is excised and the metal debris completely removed.