Conclusions Revisions and reoperations are more frequent and occur earlier with metal-on-metal hip resurfacing , except when discontinued devices are removed from the analyses .
Background Metal-on-metal hip resurfacing was developed for younger , active patients as an alternative to THA , but it remains controversial .
Study heterogeneity , inconsistent outcome definitions , and unst and ardized outcome measures challenge our ability to compare arthroplasty outcomes studies .
Questions / purpose sWe asked how early revisions or reoperations ( within 5 years of surgery ) and overall revisions , adverse events , and postoperative component malalignment compare among studies of metal-on-metal hip resurfacing with THA  among patients with hip osteoarthritis .
Secondarily , we compared the revision frequency identified in the systematic review with revisions reported in four major joint replacement registries .
Early clinical experience with the use of the Birmingham hip resurfacing system.
This study review s the early clinical experience with the  Birmingham Hip resurfacing system ( Smith & Nephew , Memphis , Tenn ) in the United States since its approval by the FDA . A total of 230 patients were followed for a mean of 16 months ( range , 6 months ) . There was a significant improvement in the mean preoperative Oxford hip score at the latest follow-up ( 44 points [ range , 30 - 58 points ] to 17 points [ range , 12 - 28 points ] ) . The most commonly used femoral component was 50 mm , and the mean duration of the procedures was 95 minutes ( range , 65 - 180 min ) . there were 3 revisions ( 1.3 % ) . Early results are favorable . As with any device , there is a continuing need for longterm monitoring and large-scale epidemiologic surveillance
Conclusions Revisions and reoperations are more frequent and occur earlier with metal-on-metal hip resurfacing , except when discontinued devices are removed from the analyses .
Background Metal-on-metal hip resurfacing was developed for younger , active patients as an alternative to THA , but it remains controversial .
Study heterogeneity , inconsistent outcome definitions , and unst and ardized outcome measures challenge our ability to compare arthroplasty outcomes studies .
Questions / purpose sWe asked how early revisions or reoperations ( within 5 years of surgery ) and overall revisions , adverse events , and postoperative component malalignment compare among studies of metal-on-metal hip resurfacing with THA  among patients with hip osteoarthritis .
Secondarily , we compared the revision frequency identified in the systematic review with revisions reported in four major joint replacement registries .