title: The effectiveness of metal on metal hip resurfacing: a systematic review of the available evidence published before 2002.
abstract: BACKGROUND
  Conventional total hip replacement (THR) may be felt to carry too high a risk of failure over a patient's lifetime, especially in young people. There is increasing interest in metal on metal hip resurfacing arthroplasty (MoM) as this offers a bone-conserving option for treating those patients who are not considered eligible for THR. We aim to evaluate the effectiveness of MoM for treatment of hip disease, and compare it with alternative treatments for hip disease offered within the UK.
  
  
  METHODS
  A systematic review was carried out to identify the relevant literature on MoM published before 2002. As watchful waiting and total hip replacement are alternative methods commonly used to alleviate the symptoms of degenerative joint disease of the hip, we compared MoM with these.
  
  
  RESULTS
  The data on the effectiveness of MoM are scarce, as it is a relatively new technique and at present only short-term results are available.
  
  
  CONCLUSIONS
  It is not possible to make any firm conclusions about the effectiveness of MoM based on these early results. While the short-term results are promising, it is unclear if such results would be replicated in more rigorous studies, and what the long-term performance might be. Further research is needed which ideally should involve long-term randomised comparisons of MoM with alternative approaches to the clinical management of hip disease.
authors.affiliation: Department of Public Health, University of Aberdeen, Aberdeen, UK. l.wyness@abdn.ac.uk
authors.forename: Laura
authors.initials: L
authors.lastname: Wyness
authors.forename: Luke
authors.initials: L
authors.lastname: Vale
authors.forename: Kirsty
authors.initials: K
authors.lastname: McCormack
authors.forename: Adrian
authors.initials: A
authors.lastname: Grant
authors.forename: Miriam
authors.initials: M
authors.lastname: Brazzelli
mesh_terms: D000367:Age Factors; D019644:Arthroplasty, Replacement, Hip / Q000191:economics / Q000295:instrumentation / Q000379:methods; D003362:Cost-Benefit Analysis; D019317:Evidence-Based Medicine; D006622:Hip Prosthesis / Q000191:economics; D006801:Humans; D008670:Metals; D015207:Osteoarthritis, Hip / Q000601:surgery*; D013673:Technology Assessment, Biomedical; D016896:Treatment Outcome
chemical_list: D008670:Metals