Article

The failure of previous generations of hip resurfacings was essentially a consequence of the use inappropriate materials, poor implant design, and inadequate instrumentation. It was not an inherent problem with the procedure itself. The early results of contemporary hip resurfacings are encouraging. The complications commonly seen in the 1970s and 1980s, such as early implant loosening and femoral neck fracture, are rare. Although early results should be regarded with caution, the present generation of metal-on-metal surface replacements potentially offers ultimate bone preservation and restoration of function in appropriately selected young patients. Resurfacing implants demand high manufacturing standards to produce low-wear bearings consistently. Background research and better understanding of implant failure suggest that hip resurfacing technology has now developed beyond that of an experimental procedure. Concerns remain with the long-term biologic effects of the elevated metal ion levels found in all patients with
metal-on-metal bearings in situ, although to date there is no evidence of any adverse clinical effect. Only long-term results and experience with this technology in the wider orthopedic community will determine whether the results will be durable or whether hip resurfacing will simply become a bone-conserving intervention before conventional total hip replacement. © 2005 Elsevier Inc. All rights reserved.

Langue : ANGLAIS