Metal-metal hip replacement: Indications for intervention

Metal-on-metal bearing surfaces were frequently used because of their potential for increased stability and lower wear rates. However, data reported by multiple nation-wide registries over the past 5 years, has demonstrated an increase in failure rates compared to metal-on-polyethylene bearings. In addition, adverse local tissue reactions associated with pseudotumors and destruction of the soft tissue around the joint have led to revision of these implants. Currently, there is no definitive algorithm to manage these patients and no single test should be used to determine treatment. This review discusses an evidence-based approach in managing this patient population.