Hip resurfacing: indications, results, and conclusions.

Hip resurfacing using metal-on-metal bearings has increased in popularity as a viable treatment option for young, active patients with osteoarthritis. Theoretic advantages of this procedure include preservation of bone stock, reduction in osteolysis, and a reduced risk of dislocation when compared with conventional hip arthroplasty with smaller diameter metal-on-polyethylene bearings. Concerns associated with the use of metal-on-metal bearings during hip resurfacing include the production of metal ions with unknown carcinogenic and immunologic effects. The long-term survival of the modern metal-on-metal hip resurfacing implant is also unknown. Hip resurfacing accounts for 7.5% of all hip replacements in Australia and has a 2.2% revision rate, with femoral fracture being the most common reason for revision. The cumulative survival rate at the authors' institution is 99.14% at 3-year follow-up.