COVID-19 Update: We are currently shipping orders daily. However, due to transit disruptions in some geographies, deliveries may be delayed. To provide all customers with timely access to content, we are offering 50% off Science and Technology Print & eBook bundle options. Terms & conditions.
The Hip Resurfacing Handbook - 1st Edition - ISBN: 9781845699482, 9780857096203

The Hip Resurfacing Handbook

1st Edition

A Practical Guide to the Use and Management of Modern Hip Resurfacings

Editors: K De Smet P. Campbell C Van Der Straeten
Hardcover ISBN: 9781845699482
eBook ISBN: 9780857096203
Imprint: Woodhead Publishing
Published Date: 22nd April 2013
Page Count: 576
Sales tax will be calculated at check-out Price includes VAT/GST
Price includes VAT/GST

Institutional Subscription

Secure Checkout

Personal information is secured with SSL technology.

Free Shipping

Free global shipping
No minimum order.

Table of Contents


Contributor contact details

Woodhead Publishing Series in Biomaterials




Part I: Hip resurfacing designs

Chapter 1: The advanced ceramic coated implant systems (ACCIS) hip resurfacing prosthesis


1.1 Introduction

1.2 Information about the Advanced Ceramic Coated Implant Systems (ACCIS) Prostheses

1.3 Recommended Advanced Ceramic Coated Implant Systems (ACCIS) Surgical Technique

1.4 Metal Ion Measurements in Patients after Advanced Ceramic Coated Implant Systems (ACCIS) Hip Arthroplasty

1.5 Conclusion

1.6 Sources of Further Information and Advice

Chapter 2: The ADEPT® hip resurfacing prosthesis


2.1 Introduction

2.2 Design Rationale

2.3 Surgical Technique

2.4 Clinical Results

Chapter 3: The DePuy Articular Surface Replacement (ASRâ„¢) hip resurfacing prosthesis


3.1 Introduction

3.2 Design Rationale

3.3 Instrumentation

3.4 Clinical Results

3.5 Summary

Chapter 4: The Birmingham Hip Resurfacing (BHR) prosthesis


4.1 Introduction

4.2 Design Rationale

4.3 Surgical Technique

4.4 Clinical Results

Chapter 5: The Conserve® Plus hip resurfacing prosthesis


5.1 Introduction

5.2 Design Rationale

5.3 Surgical Technique

5.4 Long-Term Results

Chapter 6: The Cormetâ„¢ hip resurfacing prosthesis


6.1 Introduction

6.2 Design Rationale

6.3 Surgical Technique

6.4 Clinical Results

Chapter 7: The Durom hip resurfacing prosthesis


7.1 Introduction

7.2 Design Rationale

7.3 Surgical Technique

7.4 Clinical Results

7.5 Sources of Further Information and Advice

Chapter 8: The ESKA hip resurfacing prosthesis


8.1 Introduction

8.2 Design Rationale

8.3 Surgical Technique

8.4 Clinical Results

Chapter 9: The ICON hip resurfacing prosthesis


9.1 Introduction

9.2 Design Rationale

9.3 Surgical Technique

9.4 Clinical Results

Chapter 10: The modular hip resurfacing system (MRS) prosthesis


10.1 Introduction

10.2 Design Rationale

10.3 Clinical Results

Chapter 11: The MIHR International® hip resurfacing prosthesis


11.1 Introduction

11.2 Design Rationale

11.3 Surgical Technique

11.4 Clinical Results

Chapter 12: The MITCH hip resurfacing prosthesis


12.1 Introduction

12.2 Design Rationale

12.3 Clinical Results

12.4 Acknowledgements

Chapter 13: The BIOMET ReCap hip resurfacing prosthesis


13.1 Introduction

13.2 Design Rationale

13.3 Surgical Technique

13.4 Clinical Results

Chapter 14: The ROMAX® hip resurfacing prosthesis


14.1 Introduction

14.2 Design Rationale

14.3 Surgical Technique

14.4 Clinical Results

Chapter 15: The Tornier DynaMoM hip resurfacing prosthesis


15.1 Introduction

15.2 Design Rationale

15.3 Surgical Technique

Chapter 16: Design issues and comparison of hip resurfacing prostheses


16.1 Introduction

16.2 General Issues: Component Identification and Metallurgy

16.3 Component Sizes

16.4 The Acetabular Cup Design

16.5 The Femoral Head Design

16.6 Comparing Hip Resurfacing Designs

Part II: Clinical follow-up

Chapter 17: Clinical follow-up of the hip resurfacing patient


17.1 Introduction

17.2 Pre-Operative Examination

17.3 Post-Operative Examination

17.4 Treatment Options for Symptomatic Hip Resurfacing Patients

Chapter 18: Acoustic phenomena in hip resurfacing


18.1 Introduction: the Incidence of Noise in Hip Resurfacing

18.2 Acoustic Phenomena in Resurfacings at the Specialist Orthopaedics Group, Sydney, Australia

18.3 Acoustic Phenomena in Resurfacings at the Anca Clinic, Ghent, Belgium

Chapter 19: Rehabilitation of patients after hip resurfacing


19.1 Introduction

19.2 Post-Operative Physical Therapy Whilst in Hospital

19.3 Physical Therapy After Discharge from the Hospital

19.4 Milestones in Rehabilitation

19n5 Patient Activities after Hip Resurfacing

Chapter 20: The use of radiography to evaluate hip resurfacing


20.1 Introduction: Indications for Resurfacing

20.2 Indications/Contra-Indications for Resurfacing: Osteopenia, Osteoporosis, Osteoarthritis and Osteophytes

20.3 Assessing Femoral Abnormalities

20.4 Assessing Acetabular Abnormalities

20.5 Assessing Other Abnormalities

20.6 Using Radiographs in Pre-Operative Templating

20.7 Using Radiographs to Analyse Hip Implants

20.8 Evaluation of the Acetabular Cup

20.9 Evaluation of the Femoral Oomponent

20.10 Assessing Hip Resurfacing Pathology from X-Ray Analysis

20.11 Conclusions

Chapter 21: The use of bone scintigraphy to evaluate hip resurfacing


21.1 Introduction

21.2 Bone Scans in the Normal Hip Joint

21.3 Bone Scans in Hip Disease

21.4 Bone Scans in Total Hip Arthroplasty (THA)

21.5 Bone Scans in Resurfacing Hip Arthroplasty (RHA)

21.6 Bone Scans in Adverse Tissue Reactions

21.7 Conclusion

Chapter 22: The use of ultrasound (US) to evaluate hip resurfacing (HR)


22.1 Introduction

22.2 Advantages and Disadvantages of Ultrasound (US)

22.3 The Role of Ultrasound (US) in Assessing Painful Hip Resurfacing (HR)

22.4 Ultrasound (US) Techniques

22.5 Detection of Reactive Mass (‘Pseudotumour’)

22.6 Detection of other Pathologies

22.7 Case Study

Chapter 23: The use of computerized tomography (CT) to evaluate hip resurfacing


23.1 Introduction: The Science of Computerized Tomography (CT)

23.2 The use of Computerized Tomography (CT) Scans for Pre-Operative Evaluation and Planning of Hip Resurfacing

23.3 The use of Computerized Tomography (CT) Scans to Evaluate Hip Resurfacings

23.4 Case Studies From the Isala Clinic, Zwolle, the Netherlands

23.5 Conclusions

Chapter 24: The use of magnetic resonance imaging (MRI) to evaluate hip resurfacing


24.1 Introduction: The Science of Magnetic Resonance Imaging (MRI)

24.2 Distinguishing Normal and Pathological Structures

24.3 Magnetic Resonance Imaging (MRI) Evaluation of Bone

24.4 Magnetic Resonance Imaging (MRI) Evaluation of Soft Tissues

24.5 Case Studies

24.6 Conclusions

24.7 Acknowledgement

Chapter 25: The use of positron emission tomography (PET) to evaluate hip resurfacing


25.4 Conclusion

Chapter 26: The use of dual energy X-ray absorptiometry (DEXA) to evaluate hip resurfacing


26.1 Introduction

26.2 Analyzing Bone Using Dual Energy X-Ray Absorptiometry (DEXA)

26.3 The Clinical Application of Dual Energy X-Ray Absorptiometry (DEXA) in Hip Resurfacing

26.4 Using Dual Energy X-Ray Absorptiometry (DEXA) to Monitor Post-Operative Changes in Bone Density

26.5 Bone Mineral Density (BMD) in Osteonecrosis of the Femoral Head

Chapter 27: The use of metal ion level measurements to evaluate hip resurfacing


27.1 Introduction

27.2 Wear Particles from the use of Cobalt-Chrome Alloys in Hip Resurfacing

27.3 Methodological Issues in Measuring Metal Ion Concentration

27.4 Metal Ion Levels After Metal-On-Metal (MOM) Hip Replacement

27.5 Factors Affecting Metal Ion Levels

27.6 Conclusion: The Diagnostic Use of Metal Ion Measurement

Chapter 28: The practical application of metal ion level measurement in evaluating hip resurfacing


28.1 Introduction

28.2 Protocol for Metal Ion Measurement

28.3 Metal Ion Concentration Units, Sample Sources and Conversion Factors

28.4 Interpretation of Metal Ion Levels: Normal Cobalt and Chromium Levels and Safe Upper Limits for Unilateral and Bilateral Metal-on-Metal (MOM) Hip Resurfacing Arthroplasties

28.5 The Evolution of Metal Ion Levels During Run-in and Steady-State Wear in Hip Resurfacing

28.6 Metal Ion Levels with Different Hip Resurfacing Designs

28.7 The Influence of Patient Activity on Metal Ion Levels

28.8 Toxicity of Metal Ions

28.9 Case Studies

28.10 Conclusion

Part III: Operating techniques

Chapter 29: Comparing surgical techniques in hip resurfacing


29.1 Introduction

29.2 Comparing Posterior, Modified Lateral, Trochanteric and Anterior Approaches

Chapter 30: Surgical technique in hip resurfacing: the modified posterior approach


30.1 Introduction

30.2 Patient Positioning

30.3 Surgical Exposure

30.4 Femoral Sizing

30.5 Acetabular Procedure

30.6 Femoral Preparation

30.7 Implantation and Closure

Chapter 31: Surgical technique in hip resurfacing: the anterior approach


31.1 Introduction: Rationale for the Anterior Approach

31.2 Patient Positioning and Surgical Exposure

31.3 Femoral Head Preparation

31.4 Acetabular Component Preparation

31.5 Post-Operative Recovery

31.6 Clinical Experience with the Anterior Approach

Chapter 32: Tips and tricks for successful hip resurfacing


32.1 Introduction: General Issues

32.2 Bilateral Surgery

32.3 Patient Positioning

32.4 Exposure

32.5 Preserving Soft Tissue

32.6 Acetabular Procedure

32.7 Femoral Procedure

32.8 Resurfacing in Hip Dysplasia

Chapter 33: Surgical instruments in hip resurfacing


33.1 Introduction

33.2 Acetabular Instruments

33.3 Femoral Instruments

33.4 Instruments and Tools for Cementing

33.5 Femoral Head Impactor

33.6 Summary: An Ideal Instrument System

Chapter 34: Anaesthesia in hip resurfacing


34.1 Introduction

34.2 General issues

34.3 Unilateral resurfacing

34.4 Bilateral resurfacing

34.5 Revision Of a hip resurfacing

34.6 Complications

34.7 Treatments To reduce blood loss

34.8 Practical application Of anaesthesia protocols: the authors' experience

34.9 Post-operative pain management

Chapter 35: Revision surgery for failed hip resurfacing


35.1 Introduction

35.2 Remedial Surgery without Implant Revision

35.3 How to Diagnose a Failed HIP Resurfacing

35.4 Reasons for Revision of a HIP Resurfacing

35.5 Options in Revision Surgery

35.6 Surgical Techniques in Revision Surgery

35.7 Complications in Revision of HIP Resurfacing

35.8 Summary: Decision Tree for HIP Resurfacing Follow-up and Revision

Part IV: Failure modes in hip resurfacing

Chapter 36: Implant retrieval studies showing failure modes in hip resurfacing


36.1 Introduction: the importance Of retrieval studies

36.2 Implant retrieval methods

36.3 Wear measurement

36.4 Femoral sectioning For cement And bone analyses

36.5 Failure modes shown by retrieval studies

36.6 Examples Of well-functioning hip resurfacings

Chapter 37: Case studies of femoral neck fractures in hip resurfacing


37.1 Introduction

37.2 Femoral neck fractures: CASE 1

37.3 Femoral neck fractures: CASE 2

37.4 Femoral neck fractures: CASE 3

37.5 Femoral neck fractures: CAsE 4

37.6 Femoral neck fractures: CAsE 5

37.7 Femoral neck fractures: CASE 6

Chapter 38: Case studies of femoral loosening and femoral head collapse in hip resurfacing


38.1 Introduction

38.2 Femoral Loosening/Head Collapse: Case 1

38.3 Femoral Loosening/Head Collapse: Case 2

38.4 Femoral Loosening/Head Collapse: Case 3

38.5 Femoral Loosening/Head Collapse: Case 4

38.6 Femoral Loosening/Head Collapse: Case 5

Chapter 39: Case studies of acetabular loosening in hip resurfacing


39.1 Introduction

39.2 Surface Coatings for Acetabular Fixation

39.3 Acetabular Loosening: CASE 1

39.4 Acetabular Loosening: CASE 2

39.5 Acetabular Loosening: CASE 3

39.6 Acetabular Loosening: CASE 4

Chapter 40: Case studies of acetabular malposition and high wear in hip resurfacing


40.1 Introduction

40.2 Acetabular Malposition/High Wear: CASE 1

40.3 Acetabular Malposition/High Wear: CASE 2

40.4 Acetabular Malposition/High Wear: CASE 3

40.5 Acetabular Malposition/High Wear: CASE 4

40.6 Acetabular Malposition/High Wear: CASE 5

Chapter 41: Case studies of suspected metal allergy in hip resurfacing


41.1 Introduction

41.2 Aseptic Lymphocyte-Dominated Vasculitis-Associated Lesion (ALVAL)

41.3 Suspected Metal Allergy: CASE 1

41.4 Suspected Metal Allergy: CASE 2

41.5 Suspected Metal Allergy: CASE 3

Part V: General hip resurfacing issues

Chapter 42: The patient experience of hip resurfacing


42.1 Introduction

42.2 Patient Testimonial: Combined Revision of a Malpositioned Hip Resurfacing and a Primary Hip Resurfacing (Paolo Bolaffio)

42.3 Patient Testimonial: Hip Resurfacing and the Experience of Infection (John Buch)

42.4 Patient Testimonial: The Experience of Metal Allergy (Patient X)

42.5 Patient Testimonial: Bilateral Hip Resurfacing (Peggy Gabriel)

42.6 Patient Testimonial: Bilateral Hip Resurfacing (Dru Dixon)

Chapter 43: Comparing hip resurfacing arthroplasty (HRA) and total hip arthroplasty (THA)


43.1 Introduction

43.2 Biomechanical Differences Between Hip Resurfacing Arthroplasty (HRA) and Total Hip Arthroplasty (THA)

43.3 Clinical Studies Comparing Hip Resurfacing Arthroplasty (HRA) and Total Hip Arthroplasty (THA)

43.4 Comparing Outcomes of Hip Resurfacing Arthroplasty (HRA) and Total Hip Arthroplasty (THA): Complications and Revisions

43.5 Comparing Survivorship

43.6 Assessing Hip Resurfacing Arthroplasty (HRA): The Consensus of the 2009 and 2010 Advanced Resurfacing Courses in Ghent

43.7 Conclusion

Chapter 44: The current regulatory status of hip resurfacing arthroplasty (HRA)


44.1 Introduction: US Food and Drug Administration (FDA) Classification and Regulation of Metal-on-Metal (MOM) Hips

44.2 European Union Regulations for Metal-on-Metal (MOM) Hips

44.3 Regulatory Status Table

Chapter 45: Websites relating to hip resurfacing




Hip resurfacing arthroplasty (HRA) using metal-on-metal bearings is an established but specialised technique in joint surgery. Based on the experience of leading experts in the field, The hip resurfacing handbook provides a comprehensive reference for all aspects of this important procedure.

The first part of the book reviews and compares all the major hip resurfacing prostheses, their key design features, relevant surgical techniques and clinical results. Part two discusses clinical follow-up of the hip resurfacing patient, including pre- and post-operative examination, acoustic phenomena and rehabilitation. It also covers the use of techniques such as radiography and metal ion measurement, as well as bone scans, ultrasound, CT, MRI, PET and DEXA, to evaluate hip resurfacings. Part three reviews best practice in surgical technique, including the modified posterior and anterior approaches, as well as instrumentation, anaesthesia and revision surgery. Based on extensive retrieval studies, Part four includes examples of the main failure modes in HRA. The final part of the book includes patients’ own experiences, a comparison of HRA with total hip arthroplasty (THA), regulatory issues and relevant web sites.

Comprehensive in its scope and authoritative in its coverage, The hip resurfacing handbook is a standard work for orthopaedic surgeons and all those involved in HRA.

Key Features

  • A standard work for orthopaedic surgeons and all those involved in HRA
  • Reviews and compares all the major hip resurfacing prostheses, their key design features, relevant surgical techniques and clinical results
  • Clinical follow-up of the patient is discussed


Surgeons specializing in hip replacement and joint surgeons


No. of pages:
© Woodhead Publishing 2013
22nd April 2013
Woodhead Publishing
Hardcover ISBN:
eBook ISBN:


For the orthopaedic surgeon who wishes to consider undertaking hip resurfacing as part of a clinical workload, they would definitely benefit from the wealth of experience and the comparative data from the large range of designs available described in this book., R J Minns PhD, SCOPE, IPEM

Ratings and Reviews

About the Editors

K De Smet

Koen De Smet is one of the world’s leading hip surgeons, having performed more than 3500 hip resurfacings. His annual Advanced Hip Resurfacing Course is widely regarded as a key source of best practice for HRA.

Affiliations and Expertise

ANCA Clinic, Belgium

P. Campbell

Pat Campbell is Director of the Implant Retrieval Laboratory and a Professor in the Department of Orthopaedic Surgery at The University of California Los Angeles (UCLA). She is a leading expert on implant retrieval and analysis.

Affiliations and Expertise

Courtauld Institute of Biochemistry, The Middlesex Hospital Medical School, London, U.K.

C Van Der Straeten

Catherine Van Der Straeten is a Rheumatologist and an Independent Consultant in Clinical Research with extensive experience in designing and performing hip resurfacing follow-up studies, including ion level monitoring.

Affiliations and Expertise

Consultant, Belgium