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The ‘best’ hip replacement

A recent study in the British Medical Journal (Comparative Assessment of Implantable Hip Devices With Different Bearing Surfaces. Systematic Appraisal of Evidence. Art Sedrakyan; Sharon-Lise T Normand; Stefan Dabic; Samantha Jacobs; Stephen Graves; Danica Marinac-Dabic) set out to ‘determine comparative safety and effectiveness of combinations of bearing surfaces of hip implants’. This was a large meta analysis which showed that there was no difference in the outcome of more advanced bearings such as metal-on-metal or ceramic-on-ceramic compared to more traditional bearings such as metal-on-polyethylene. The implication of this study is that there is no point in using more expensive materials when cheap and cheerful ones seem to perform just as well. Whilst this common sense approach appears at first glance to be quite compelling, it ignores the fact that conventional hip replacements wear out quite quickly when used in younger men and women. The authors stated that ‘none of the studies reported age specific or sex specific analyses, and none reported race or patients’ comorbidity, such as diabetes and obesity’. Unfortunately, these factors are very important when a surgeon decides which hip replacement should be used for a particular patient. One size does not fit all! We know that large diameter metal-on-metal hip replacements don’t work well, but there is some evidence that ceramic bearings are getting good results in younger patients. This is a rapidly growing and controversial area, and underlines the fact that we know less than we think about implants and their effects on the human body.

One Response

  1. The recent recall of hip implant systems manufactured by DePuy Orthopaedics, has brought attention to the safety of hip implant systems across the U.S. The Profemur® hip system manufactured by Wright Medical Group is under fire because patients are starting to report problems in as little as three years after implantation.

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Types of treatments available at Latham Hip Surgery
  • Treatments
  • Hip Replacement

    Total Hip Replacement or THR is one of the most successful hip operations in orthopaedic surgery. Tens of thousands of hip replacements are performed each year…

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  • Hip Resurfacing

    Hip resurfacing was developed to treat painful arthritis in younger and active patients. It’s now an established technique, and the results are usually excellent in carefully selected patients…

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  • Revision Hip Surgery

    Hip replacement surgery can be life changing for those dealing with pain on a daily basis. Unfortunately, even a replacement hip can wear out…

    Click here to find out more
  • Hip Replacement

    Total Hip Replacement or THR is one of the most successful hip operations in orthopaedic surgery. Thousands of hip replacements are performed each year…

    Click here to find out more
  • Hip Resurfacing

    Hip resurfacing was developed to treat painful arthritis in younger and active patients. It’s a relatively new technique, but the results are usually excellent…

    Click here to find out more
  • Revision Hip Surgery

    Hip replacement surgery can be life changing for those dealing with pain on a daily basis. Unfortunately, even a replacement hip can wear out…

    Click here to find out more