In April 2002, the National Institute of Clinical Excellence, the government body which reviews and gives judgement on all products associated with the medical and pharmaceutical industries, issued guidance that recommended the selective use of metal on metal hip resurfacing.

The main points of the guidance state that:

• Hip resurfacing is considered as an option for people with advanced hip disease who would otherwise receive and are likely to outlive a conventional primary total hip replacement;
• Hip resurfacing arthroplasty should only be performed by a surgeon who is trained specifically in the technique;
• The informed consent of the patient should include information about the safety and reliability of the device and the likely outcome of revision surgery in comparison to conventional total hip replacement.

Additionally, due to the need to gather clinical effectiveness and cost data on the use of this technology, details of all patients should be submitted for inclusion in the UK national joint register.
The full NICE ‘Final Appraisal Determination on metal on metal hip arthroplasty’ is available on the NICE website at www.nice.org.uk .