Hip Replacement Surgery - A Quick Guide

There are several different types of hip replacement surgery, these are:

Metal on Plastic articulating hips

The success of total hip replacement was initially due to the pioneering work of Sir John Charnley forty years ago. After several failed designs he developed what then became the standard cemented hip replacement: a cemented plastic socket combined with a cemented metal stem. Over the past 40 years, there have been many improvements in both the materials and the methods used to hold the components in place. Today, the most commonly used bone cement is an acrylic polymer called polymethylmethacrylate (PMMA). 

Ceramic on Ceramic Bearings

Ceramics are several times harder than metal and wear is minimal (and hence produce much fewer wear particles. However, ceramics are brittle and early designs sometimes broke although the newer designs are now much more durable. The ceramic socket cannot be cemented into the pelvis and is fixed in a metal uncemented shell which press-fits into the natural hip socket. Unfortunately a small percentage (1 or 2) of ceramic bearings emit an audible squeak! 

Metal on Metal Bearings

A metal ball articulating with a metal socket was the first ever total hip replacement (implanted by the surgeon Philip Wiles at the Middlesex Hospital, London, in the 1930s). Metal bearings wear less than plastic but still generate wear particles and also release metal ions which can cause inflammation and problems for a small percentage of patients.

For more information on hip replacement surgery and hip preservation surgery please read the articles below.

See also the Total Health Guide to Hip Replacement