Hip Resurfacing has “Unacceptably High” Failure Rates

October 2, 2012 — According to a new study published in The Lancet, hip resurfacing procedures have a high rate of failure compared to traditional metal-on-plastic hip implants, especially for women and small men. Although hip resurfacing implants are supposed to last for 10 years, the study found that only large, middle-aged men typically had implants last that long.

Dr. Ashley W. Blom of the University of Bristol, who led the study, said that “Resurfacing failure rates in women were unacceptably high. In view of these findings, we recommend that resurfacing procedures are not undertaken in women.”

The researchers analyzed data from the National Joint Registry of England and Wales. The United States currently lacks a similar registry, or any tracking system for hip implant patient outcomes. The registry included information on 32,000 people who had a hip resurfacing procedure between April 2003 and September 2011. The researchers looked to see how many implants failed within seven years, and compared this rate to traditional, total hip implants.

On average, about 5% of hip resurfacing implants failed within five years, compared to less than 2% of total hip implants. However, in women, the five-year failure rate of hip resurfacing implants was about 10% — five-times higher than a total hip implant. This statistic led researchers to caution that hip resurfacing implants should not be used in women. High failure rates were also seen in small men.

Hip resurfacing is a procedure where a surgeon re-shapes and caps a patient’s damaged hip with a metal surface. This is an alternative to “full” or “total” hip replacement surgery, in which the “ball” part of the hip is completely replaced. It is marketed toward younger, more active people because the procedure leaves more bone in the hip, which could make it easier to perform a total hip implant later in life, if necessary.

Hip resurfacing implants are metal-on-metal hip implants. As the metal parts grind together, they can shed tiny metal particles into the body. The metal debris can irritate tissues in the hip, cause bone loss, pain, decreased mobility, and other complications. In severe cases, additional corrective surgery may be necessary to repair the implant.

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