The DePuy Articular Surface Replacement (ASR™) hip resurfacing prosthesis

Abstract: The Articular Surface Replacement (ASR TM , DePuy) was designed to be the most bone-preserving hip resurfacing on the market with a thin low profile acetabular shell and a reduced size of the stem. However, the shallow acetabular shell is associated with a small coverage angle leading to increased edge loading, especially in the smaller size range. This causes early wear with generation of metal ions and particles eliciting adverse local soft tissue reactions and osteolysis. The higher than expected revision burden demonstrated by Arthroplasty Registries data and results of non-designer surgeons with up to 13% revisions at 7 years led to withdrawal from the market of the ASR in October 2009.