Hip resurfacing

Patients with joint pain and dysfunction caused by noninflammatory arthritis (degenerative joint disease) such as osteoarthritis, traumatic arthritis, avascular necrosis, dysplasia, or inflammatory arthritis such as rheumatoid arthritis, may be treated with hip replacement technologies including hip resurfacing (HR). Hip resurfacing is proposed as a bone conserving alternative to the conventional total hip replacement or arthroplasty (THA) after more conservative medical therapy fails. 

Hip resurfacing was first reviewed by the HTA program in 2009.

  • In 2012, an update literature search was conducted on hip resurfacing to determine if newly available published evidence could change the original coverage determination.
  • In 2013, the HCA director selected hip resurfacing for rereview based on newly available published evidence that could change the original coverage determination.

Status: Decision completed

Why is hip resurfacing being reviewed?

Metal-on-metal (MoM) bearing safety concerns: MoM hip systems, both total hip arthroplasty (THA) and hip replacement (HR), have received widespread usage. As a result, more information has become available regarding the safety profile and clinical performance of these systems. Data from national total joint registries, as well as, peer-reviewed journal publications and presentations at scientific meetings have suggested increases in potential safety issues associated with MoM hip systems.

Primary criteria ranking

  • Safety = High
  • Efficacy = Medium
  • Cost = Medium

Documentation

Assessment timeline 

  • Draft key questions published: May 23, 2013
  • Public comment period: May 23 to June 7, 2013
  • Draft report published: August 27, 2013
  • Public comment period: August 27 to September 26, 2013
  • Final report published: October 1, 2013
  • HTCC public meeting: November 15, 2013