HTA Details
Metal-on-Metal Hip Resurfacing Arthroplasty
- Publication date
-
2012-August-01
- Status
- Final
- Topic Area
- Bones, Joints and Muscles
- Recommendation
-
Ontario Health Technology Advisory Committee Recommendations
- Metal-on-metal hip resurfacing arthroplasty (HRA) is a reasonable treatment option for osteoarthritis patients who meet the appropriate criteria
- Metal-on-metal HRA should only be performed by surgeons who have appropriate training and who have acquired a high level of experience by performing a high annual volume of total hip arthroplasties and metal-on-metal HRAs
- Ministry Response
-
The Ministry of Health and Long-Term Care endorses these recommendations.
-
To read the full OHTAC Recommendation Report for this topic, contact our Health Innovation team using the contact form to request a digital copy.
Total hip replacement has long been considered the treatment of choice for older patients with advanced osteoarthritis of the hip. However, for younger and more active people, some surgeons favour metal-on-metal hip resurfacing arthroplasty. In this technique, a metal cap is placed on the top end of the thigh bone (femur) to cover the damaged surface of the bone, and a metal cup is placed in the hipbone socket. The goal is to preserve the thigh bone and restore movement to the joint.
The worldwide withdrawal of one hip resurfacing implant in 2010, because of higher-than-expected rates of surgeries having to be redone, resulted in some uncertainty regarding other implants. Ontario Health reviewed the evidence and compared the revision rates for hip resurfacing arthroplasty implants with the benchmark set by the National Institute for Clinical Excellence, and explored potential safety issues related to exposure to high levels of metal ions.
Last Updated: February 24, 2026
