Current concepts of metal-on-metal hip resurfacing

The second-generation, metal-on-metal (MOM) bearing for total hip replacements was launched in the 1980s, and resurfacing followed in the mid-1990s. Remaining challenges include patient selection, long-term bone remodeling of the femoral resurfacing, and consideration of adverse MOM wear conditions. Precise understanding of manufacturing variables such as alloy types, bearing diameters, design tolerances, and surface finish is imperative in obtaining clinical consistency and safety in the patient. This review examines femoral fixation, bone remodeling, and wear studies of MOM implants and provides a brief overview of the latest outcome and retrieval data and how these data integrate with the in vitro wear studies.