In April 2002, the UK National Institute for Clinical Excellence (NICE) issued guidance recommending the selective use of metal-on-metal Hip Resurfacing, used to treat hip disease.

A NICE Press release issued on the 19th June 2002 says:

“Metal-on-metal (MoM) hip resurfacing involves replacing the diseased or damaged surfaces in the hip joint with metal surfaces. Less bone has to be removed for MoM resurfacing than to fit a conventional cup and ball artificial hip joint.

NICE recommends that MoM Hip Resurfacing be considered 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. When considering a MoM Hip Resurfacing, Surgeons should bear in mind how active the individual is and that the current available clinical and cost effectiveness evidence on MoM hip resurfacing comes mainly from studies that have involved people less than 65 years of age”

Andrew Dillon, Chief Executive of NICE, said, “This is a relatively new technique which has the potential to offer benefits for particular groups of patients. It isn’t a replacement for conventional hip replacements and we need to know more about its long term durability and safety. This is one reason why we have recommended that its use is monitored, along with conventional devices, in a national joint registry.”

The NICE Report includes the following guidance on the use of metal-on-metal Hip Resurfacing:

Metal-on-metal Hip Resurfacing arthroplasty is considered as an option for people with advanced hip disease who would otherwise receive and are likely to outlive a conventional primary THR, particularly for younger patients who wish to be reasonably active.

Metal-on-metal Hip Resurfacing arthroplasty is performed only by a Surgeon who has received training specifically in this technique.

For a patient having metal-on-metal Hip Resurfacing arthroplasty, the patient’s informed consent refers specifically to current evidence on the medium- to long-term safety and reliability of metal-on-metal devices and the likely outcome of revision surgery in comparison with conventional THR's.

The full NICE “Final Appraisal Determination Metal-on-Metal Hip Resurfacing Arthroplasty” is available on the NICE website at www.nice.org.uk/page.aspx?o=30712

NICE also provide "Information For Patients - Guidance on the use of metal-on-metal Hip Resurfacing arthroplasty". This is provided in printable PDF format, and you can find it on their website at www.nice.org.uk/page.aspx?o=33566