Local and Distant Reaction to Metallic Wear Debris

Total hip arthroplasty (THA) and hip resurfacing arthroplasty (HRA) have become some of the most successful elective surgical procedures in modern medicine that it has been described as “the operation of the twentieth century”. Worldwide, it is estimated that approximately one million are implanted every year. About 270,000 hip arthroplasties are done in the United States, and this is projected to increase by 174 % between 2005 and 2030. The National Joint Registry of England and Wales reported 68,907 primary operations in 2010. The number of younger patients receiving a THA is continuously increasing. In England and Wales, 12 % of patients are younger than 55 years. In Canada, the number of patients aged less than 45 years having hip replacements during 2002 rose by 11.0 % compared with 1994.