Question
A 72 year old woman has a painful hip that was resurfaced 14 years ago.
- What implant is shown?
- What are the advantages and the current indications?
- What are the failure modes, and how do you investigate a painful resurfacing?
Answer
Implant
- Metal on metal hip resurfacing of the left hip
Advantages and indications
- Preserves femoral bone and the femoral canal
- Large head improves stability
- Restores native biomechanics
- Best results in men under 60 with femoral heads over 50 mm
- Not advised in women and small heads, which have high failure rates in registries
- Most metal on metal designs have been withdrawn
Failure modes
- Femoral neck fracture, mostly in the first year
- Adverse reaction to metal debris (pseudotumour)
- Aseptic loosening of the femoral component
- Avascular necrosis of the remaining head
- Cup malposition with edge loading
Investigation
- Blood cobalt and chromium levels
- Metal artefact reduction sequence MRI or ultrasound
- Cup inclination and version on radiographs and CT
- Exclude infection
- Revise early when there are soft tissue reactions
Related pages
Author Contributions
Orthofracs team
Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.