About Hip Implants

Well over 300,000 hip implant operations are performed in the United States each year. Recently, it has been reported that the average age of individuals undergoing hip implant surgeries decreased from age 66 to age 65. It is expected that the average age for hip implants will continue to trend downward as more and more people are staying active through their adulthood and the trending norm is for adults to continue to be more active in their 50’s, 60’s and 70’s.

Types of Hip Implants

According to a report published by the FDA, there are currently five types of total hip replacement devices available in the US comprised of different surface materials. They are follows:

• Metal-on-Metal: The ball and socket are both made of metal.
• Metal-on-Polyethylene: The ball is metal, and the socket is plastic or has a plastic lining.
• Ceramic-on-Metal: The ball is made of ceramic and the socket has a metal lining.
• Ceramic-on-Polyethylene: The ball is ceramic, and the socket is comprised of plastic or has a plastic lining.
• Ceramic-on-Ceramic: Both the ball and socket are made of ceramic.

Why Choose Metal-on-Metal Hip Implants

Until recently, the use of metal-on-metal devices was favored in cases where implant survivorship is a factor (i.e. where the patient is younger, and it is desired to not have to replace the original implant with another in the patient’s lifetime). Metal-on-Metal hip implant devices were considered more durable and less prone to dislocation and fracture than ceramic device alternatives.

Total Hip Replacement vs. Hip Resurfacing

Individuals with advanced osteoarthritis or other degenerative hip diseases are candidates for the surgical replacement of the worn-out parts of the joint. The two most common surgical procedures performed are total hip replacement and hip resurfacing. Doctors weigh out a variety of factors when deciding the best option for each patient. Typically, the best candidates for hip resurfacing are younger (less than age 60) active males with a large frame and strong bone structure. Hip resurfacing is not restricted to males, however. Many female patients have undergone hip resurfacing procedures as well.

In a traditional total hip replacement procedure, the damaged femoral head as well as the damaged cartilage surface of the socket are removed. The femoral head is replaced with a metal stem that sits in the center of the femur. A new metal or ceramic ball is placed on the top part of the stem to replace the damaged one. A new metal socket is inserted and finally a metal, plastic or ceramic liner is placed between the new ball and socket to create a smooth gliding surface.

Unlike total hip replacement surgery, hip resurfacing procedures do not involve the removal of the femoral head. Instead, the femoral head is trimmed and covered with a smooth metal cap. The damaged socket bone and cartilage is removed and replaced with a new metal liner, however, just as in a total hip replacement.

Advantages of hip resurfacing over total hip replacement include: less bone loss, lower rates of dislocation, greater range of motion, ability to withstand higher impact sports. Disadvantages include higher degree of difficulty to perform the procedure, fractures in the femoral neck and most importantly the severe effects of metal toxicity indicated by elevated levels of metal ions in the blood. Higher than expected failure rates have been associated with Smith & Nephew’s R3 Liner and Birmingham Hip Resurfacing (BHR) system leading to voluntary recalls by the company in 2012 and 2015.

If you or a loved one have experienced injuries or complications following a total hip replacement or hip resurfacing surgery involving a metal-on-metal hip implant device, we would like to speak with you.