Surface replacement arthroplasty in the surgical treatment of hip osteoarthritis

Abstract

Surface arthroplasty, also referred to as resurfacing, is a method of sparing hip arthroplasty, which is a surgical alternative usually reserved for younger, active patients. The introduction of successive generations of implants with metal-on-metal articulation resulted in increased interest in this method of treatment. Despite the unquestionable advantages and promising initial results, resurfacing has some limitations and disadvantages. One of them is the increase in the concentration of metal ions. Although they are necessary for the proper functioning of the human body, in large amounts they can lead to serious reactions of the soft tissues adjacent to the prosthesis, including metallosis, ALVAL (Aseptic Lyphocytic Vasculitis-Associated Lesion), or the formation of pseudotumours. Despite numerous studies and scientific reports, there is a need for further work on the relationship between the concentration levels of metal ions in people after resurfacing and the biological, causal mechanisms of the development of adverse reactions in the body.