Aim: To assess the clinical and radiological performance of metal-on-metal articulations in uncemented total hip arthroplasty.

Method: Between 1996 and 2000, 60 uncemented S-ROM (Johnson & Johnson) total hip arthroplasties were performed on 55 patients with arthritis. Fifty-one of the patients (56 hips) were available for follow-up. This involved clinical assessments including completion of a hip score for each patient, along with radiological examinations.

Results: Follow-up ranged from six months to four years, with an average of 18 months. The average hip score improved from an average of 32.3 to 75.3 (maximum 84, range 53 to 84) at the latest follow-up. The average pain score improved from an average of 9.9 to 41.7 (maximum 44). No patients required revision for loosening of either the femoral or acetabular components. Thus far, there has been no radiological evidence of acetabular loosening.

Conclusions: In the short-term, the clinical performance of metal-on-metal articulations is equivalent to metal-on-polyethylene. In this group of patients, there has been no radiological evidence of acetabular loosening thus far.

Introduction: The revision of a resection arthroplasty of the hip to total hip arthroplasty is a demanding procedure with higher complication rates than those of primary hip arthroplasty.

Aim: To evaluate the outcome of revising resection arthroplasties and thereby assist in deciding which patients would benefit from the procedure.

Methods: We reviewed the experience of an orthopaedic surgeon (WJMB) who performed revisions of resection arthroplasties to total hip arthroplasties for 10 patients from 1990 to 1999. The reason for resection arthroplasty was established or suspected infection in all patients.

Results: The time since the resection arthroplasty ranged from 12 to 36 months, with an average of 14.7 months. The Harris hip scores with the resection arthroplasties ranged from 21 to 44 with an average of 38.3. The follow-up ranged from one to eight years with an average of 4.2 years. Five patients had died from other causes at the time of the study. The Harris hip scores at the latest follow-up ranged from 46 to 89 with an average of 66.

The complications included instability requiring a constrained acetabular liner, an intra-operative femoral fracture requiring a long-stem prosthesis, the breaching of a femoral cortex by a prosthesis requiring a revision and recurrence of infection in a patient who was non-compliant with the prescribed antibiotics.

Conclusions: The revision of a resection arthroplasty to a total hip arthroplasty is a demanding procedure with a high complication rate and prolonged recovery. Revising only those patients with poorly functioning resection arthroplasties optimises the possibility of a positive surgical outcome, being an improvement in pain and function.