| TA44 |
Hip disease - metal on metal hip resurfacing (TA44) |
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The clinical effectiveness and cost effectiveness of metal on metal hip resurfacing
NICE has made the following recommendations about the use of metal on metal (MoM) hip resurfacing.
- MoM hip resurfacing is recommended as an option for people with advanced hip disease who would otherwise receive a conventional primary total hip replacement (THR) and are likely to live longer than the device is likely to last.
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When considering MoM hip resurfacing surgeons should bear in mind:
- how active the individual is
- that the evidence available at the moment for the clinical effectiveness and cost effectiveness of MoM hip resurfacing comes mainly from studies that have involved people less than 65 years of age. ('Clinical effectiveness' means how well MoM hip resurfacing works, and 'cost effectiveness' mean how well it works in relation to how much it costs.)
- Information on MoM resurfacing operations carried out should be collected as part of a UK national joint registry. The information collected will help the NHS to gather evidence on both the clinical effectiveness and cost effectiveness of MoM hip resurfacing.
- The data from the national joint registry will allow researchers to find out how long MoM hip resurfacing devices last before they need to be replaced. Until more long-term evidence is available, NICE recommends that surgeons should choose a device for MoM resurfacing for which there is at least 3 years' evidence. This evidence should show that the device is likely to meet a target of less than 1 in 10 devices needing replacing over 10 years.
- MoM hip resurfacing should be performed only by surgeons who have received training in the technique.
- Surgeons should make sure that people considering having MoM hip resurfacing understand all the risks and benefits associated with it, and are aware that less is known about the safety and reliability of MoM devices than about conventional cup and ball THR devices.
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Other information
- TA44 Hip disease - metal on metal hip resurfacing: guidance (web format)
- TA44 Hip disease - metal on metal hip resurfacing: summary
How this guidance was produced
Background information
- Hip disease - metal on metal hip resurfacing: review decision - August 2011
- Review proposal - June 2011
- Review decision - July 2009
- Review Proposal - May 2009
- Review Proposal - May 2009: Appendix A - provisional matrix
- Review decision (September 2005)
- Letter to consultees on review proposal following discussion meeting at NICE
- Review proposal (February 2005)
- Health technology assessment report
- NICE recommends the selective use of metal on metal hip resurfacing
This page was last updated: 12 December 2011
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Guidance formats
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Patient
The summary of the key recommendations in the guidance written for patients, carers and those with little medical knowledge and may be used in local patient information leaflets.
Quick Reference Guide
The quick reference guide presents recommendations for health professionals
NICE Guidance
The published NICE clinical guidance, contains the recommendations for health professionals and NHS bodies.
Full Guidance
The published full clinical guidance for specialists with background, evidence, recommendations and methods used.
