(iv) Metal on metal hip replacement

The use of metal on metal bearings in hip replacement has rapidly gained popularity during the last decade. This is probably due to: (a) the problems associated with wear of traditional bearing couples, (b) the increased numbers of younger patients undergoing hip replacement and (c) the superior theoretical tribiological characteristics. However, following this widespread adoption of the metal on metal prosthesis, there has been an exponential increase in the number of adverse reports detailing reactions to metal debris. This review describes the history, development and current evidence surrounding metal on metal hip replacement.