Metal-on-Metal Resurfacing and the Cost to the Nation: A Conservative Estimate of the Unexpected Costs Required to Implement the New Metal-on-Metal Follow-Up Programme in the UK

摘要

The past 15 years has seen resurgence in the interest in metal-on-metal hip replacements following the introduction of the hip resurfacing (HR) in the mid-1990s. Marketing of these implants has placed strong emphasis on the advantages of HRs over more conventional total hip replacements (THRs), especially for younger active individuals. Frequently cited advantages include, preservation of femoral bone stock (Schmalzried et al. 1996), less bearing surface wear (Chan et al. 1999; McMinn et al. 1996) and lower dislocation rates (Hing et al. 2007). Superior function and activity scores have also been observed (Mont et al. 2009; Venddittoli et al. 2006). However, there are a number of complications that are specific to HR. These include femoral neck fracture (Schimmin and Back 2005; Treacy et al. 2005) and avascular necrosis (Amstutz et al. 2004; Daniel et al. 2004).