Book Description

Total hip replacement (THR), or total hip arthroplasty, is a common orthopedic procedure used to restore function to patients with damaged or degenerated hips and chronic pain. Hip resurfacing arthroplasty (HRA) is another option for treating degenerative hip disease, particularly in younger patients with active lifestyles. During THR, the head of the femur is removed and replaced with a prosthesis that has a protruding ball. The ball fits into an acetabular cup that is secured to the pelvis with cement or by promoting bone ingrowth. The inside of the cup may contain a lining to reduce friction and decrease wear. Different models of hip prostheses are comprised of varying combinations of metal, ceramic or polyethylene balls, cups and liners. Implant type and mode of fixation are based on patient needs and surgeon preference. During HRA, a metal cap is placed on the femoral head to cover damaged bone and a metal shell is placed in the acetabulum. MOM hip implants, made of stainless steel, titanium or cobalt chrome, may erode and gradually release metal ions into the bloodstream resulting in toxicity. Due to adverse reactions to metal debris, MOM hips have also been associated with high failure rates and surgical revisions. This review evaluates the comparative clinical and cost-effectiveness of MOM total hip replacement versus MOP (cross-linked polyethylene) total hip replacement. The comparative clinical effectiveness of hip resurfacing versus total hip replacement in adults is also examined.