Hip Resurfacing Arthroplasty (HRA)

  • Eustathios KenanidisEmail author
  • Alexandros Stamatopoulos
  • Michail E. Klontzas
  • Andreas Leonidou
  • Eleftherios TsiridisEmail author
  • Lafayette de Azevedo Lage
  • Yusuf Mirza
  • Sujith Konan
  • Fares S. Haddad


  • HRA is an alternative type of hip arthroplasty that is mainly used to young, active, male patients with end-stage joint arthritis with sufficient bone quality and minimal mechanical deformity.

  • The head of the femur is partially removed and reconstructed to accept a new metal head that fits a metal acetabular component [1].

  • There have been different types of the prosthesis (cemented, uncemented, and hybrid), various types of the surface-bearing materials (MoP, CoP, MoM, and CoC), and different generations of HRAs (first generation, MoP; modern hip resurfacing systems, MoM) used.

  • The first-generation MoP HRA failed mainly due to wear and wear-induced complications. During the mid-1990s, the introduction of the third-generation MoM HRA was promising as to decrease complications [2].

  • The third generation of HRA implants has a cementless, porous-coated, press-fit monoblock acetabular and a cemented femoral component and a metal-on-metal bearing articulation [3, 4].

  • Following an initial popular period during the past decade with promising results [5–7], the indications of use are rather decreasing following concerns with regard to the long-term consequences of the presence of metal ions in the blood and the plethora of questions for the reported series of adverse local tissue reactions (ALTRs) [8].

  • The excellent however published results from high-volume centres at 10–15 years in selected patient populations [9–13], the unfavourable results of the majority of registries [14], the heterogeneity of the studies, and the inconsistent outcome definitions dispute our ability to compare arthroplasty outcome studies and have a clear point of view [1].


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Eustathios Kenanidis
    • 1
    Email author
  • Alexandros Stamatopoulos
    • 1
  • Michail E. Klontzas
    • 2
  • Andreas Leonidou
    • 3
  • Eleftherios Tsiridis
    • 4
    Email author
  • Lafayette de Azevedo Lage
    • 5
  • Yusuf Mirza
    • 6
  • Sujith Konan
    • 7
  • Fares S. Haddad
    • 8
  1. 1.Academic Orthopaedic Unit, Aristotle University Medical SchoolThessalonikiGreece
  2. 2.Imperial College LondonBiological Systems Engineering LabLondonUK
  3. 3.Reading Shoulder UnitHospital & Health CareTonbridgeUK
  4. 4.Academic Orthopaedic UnitPapageorgiou General Hospital, Aristotle University Medical SchoolThessalonikiGreece
  5. 5.University of São PauloSão PauloBrazil
  6. 6.Wales DeaneryCardiffUK
  7. 7.Department of Trauma & OrthopaedicsUniversity College Hospital LondonUK
  8. 8.University College HospitalLondonUK

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