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Tom Melvin Medical Officer, Health Products Regulatory Authority, Dublin, Republic of Ireland

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Marina Torre Engineer, Senior Researcher, Istituto Superiore di Sanità, Rome, Italy

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current system for medical device regulation in Europe. The early failure and other adverse effects associated with certain metal-on-metal (MoM) hip implants were identified as an important weakness of the medical device regulatory system which needed to

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Babar Kayani University College London Hospital, London, UK

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Sujith Konan University College London Hospital, London, UK

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Atif Ayuob University College London Hospital, London, UK

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Salamah Ayyad University College London Hospital, London, UK

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Fares S. Haddad University College London Hospital, London, UK

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. Schouten R Malone AA Frampton CM Tiffen C Hooper G . Five-year follow-up of a prospective randomised trial comparing ceramic-on-metal and metal-on-metal bearing surfaces in total hip arthroplasty . Bone Joint J 2017

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George Grammatopoulos The Ottawa Hospital, Ottawa, Ontario, Canada

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Moritz Innmann Heidelberg University Hospital, Heidelberg, Germany

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Philippe Phan The Ottawa Hospital, Ottawa, Ontario, Canada

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Russell Bodner Midwest Orthopedic Institute, Sycamore, United States of America

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Geert Meermans Bravis Hospital, Roosendaal, The Netherlands

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Introduction Appropriate component orientation is important for success following hip arthroplasty ( 1 ). The significance of appropriate acetabular component (cup) orientation was further highlighted with the use of the third-generation metal-on-metal

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Søren Overgaard Department of Orthopaedic Surgery and Traumatology, Copenhagen University Hospital, Copenhagen, Denmark
Department of Clinical Medicine, Faculty of Health & Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Thomas M Grupp Aesculap AG Research & Development & Medical Scientific Affairs, Tuttlingen, Germany
Department of Orthopaedic and Trauma Surgery, Ludwig Maximilians University Munich, Musculoskeletal University Center Munich (MUM), Campus Grosshadern, Munich, Germany

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Rob GHH Nelissen Department of Orthopaedics, Leiden University Medical Center, Leiden, the Netherlands
Technical University Delft, Delft, the Netherlands

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Luca Cristofolini Department of Industrial Engineering, School of Engineering and Architecture, Alma Mater Studiorum - Università di Bologna, Bologna, Italy

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Anne Lübbeke Division of Surgery and Traumatology, Geneva University Hospitals and University of Geneva, Switzerland
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK

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Marcus Jäger Department of Orthopaedics, Trauma & Reconstructive Surgery St. Marien Hospital Mülheim an der Ruhr & Chair of Orthopaedics and Trauma Surgery University of Duisburg–Essen, Essen, Germany

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Matthias Fink TÜV Süd Product Service GmbH, Clinical Centre of Excellence, Munich Germany

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Sabine Rusch Aesculap AG Research & Development & Medical Scientific Affairs, Tuttlingen, Germany

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Hassan Achakri Zimmer Biomet, Clinical, Regulatory & Quality Affairs, Winterthur, Switzerland

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Francesco Benazzo IUSS Pavia, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy

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Dario Bergadano Medacta International SA, Medical Affairs, Castel San Pietro, Switzerland

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Georg N Duda Julius Wolff Institute and Center for Muskuloskeletal Surgery, Berlin Institute of Health at Charité Universitätsmedizin Berlin, Germany

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Christian Kaddick EndoLab Mechanical Engineering GmbH, Riedering, Germany

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Volkmar Jansson Department of Orthopaedic and Trauma Surgery, Ludwig Maximilians University Munich, Musculoskeletal University Center Munich (MUM), Campus Grosshadern, Munich, Germany

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Klaus-Peter Günther University Clinic Carl Gustav Carus, Center for Orthopaedic & Trauma Surgery, Technical University Dresden, Dresden, Germany

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large-diameter head metal-on-metal hip arthroplasty technology based on the hope of a better outcome. This turned out to be a catastrophe for many patients and is an example of enthusiastic dissemination of available new products with insufficient

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Vasileios F Pegios Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Thessaloniki, Greece
Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Thessaloniki, Greece

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Eustathios Kenanidis Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Thessaloniki, Greece
Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Thessaloniki, Greece

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Stavros Tsotsolis Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Thessaloniki, Greece
Department of Trauma and Orthopaedics, Guy’s and St Thomas’ NHS Foundation Trust, London, UK

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Michael Potoupnis Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Thessaloniki, Greece
Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Thessaloniki, Greece

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Eleftherios Tsiridis Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Thessaloniki, Greece
Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Thessaloniki, Greece

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/not known; MoM, metal-on-metal; RH, reverse hybrid; U, uncemented. Overall revision rate Eleven studies reported the revision rate for any reason ( 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 40 , 41 ), whereas one studied only the

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Martyn Porter The National Joint Registry of England, Wales, Northern Ireland and the Isle of Man, UK
Centre for Hip Surgery, Wrightington Hospital, UK

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Richard Armstrong The National Joint Registry of England, Wales, Northern Ireland and the Isle of Man, UK
Head of Health Registries, Northgate Public Services, Peoplebuilding 2, Hemel Hempstead, Hertfordshire, England

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Peter Howard The National Joint Registry of England, Wales, Northern Ireland and the Isle of Man, UK
Royal Derby Hospital, Derby, UK

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Matthew Porteous The National Joint Registry of England, Wales, Northern Ireland and the Isle of Man, UK
West Suffolk NHS Foundation Trust, UK

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J. Mark Wilkinson The National Joint Registry of England, Wales, Northern Ireland and the Isle of Man, UK
University of Sheffield, Sheffield, UK

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procedures over the lifetime of the NJR. Primary uncemented hip procedures over the lifetime of the NJR. Primary hybrid hip procedures over the lifetime of the NJR. Primary metal-on-metal hip replacements over the lifetime of the NJR

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Bengt Mjöberg Department of Orthopaedics, Lund University, Lund, Sweden

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Meyer H et al. Particle characterisation and cytokine expression in failed small-diameter metal-on-metal total hip arthroplasties . Bone Joint J 2015 ; 97-B : 917 – 923 . 12. Wang Z Liu N Shi T et al

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Peter van Schie Department of Orthopaedics, Leiden University Medical Centre, Leiden, The Netherlands
Department of Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands

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Shaho Hasan Department of Orthopaedics, Leiden University Medical Centre, Leiden, The Netherlands

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Leti van Bodegom-Vos Department of Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands

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Jan W Schoones Walaeus Library, Leiden University Medical Centre, Leiden, The Netherlands

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Rob G H H Nelissen Department of Orthopaedics, Leiden University Medical Centre, Leiden, The Netherlands

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Perla J Marang-van de Mheen Department of Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands

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many patients from unnecessary suffering was the metal-on-metal hip arthroplasty disaster, in which 20% of patients had to undergo a revision within 10 years, compared with 4% in metal-on-polyethylene arthroplasties ( 54 , 55 ). The Australian

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Charles Rivière MSK Lab, Imperial College London, UK
South West London Elective Orthopaedic Centre, UK

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Stefan Lazic South West London Elective Orthopaedic Centre, UK

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Louis Dagneaux CHU de Montpellier, France

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Catherine Van Der Straeten London Hip Unit, UK

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Justin Cobb MSK Lab, Imperial College London, UK

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Sarah Muirhead-Allwood London Hip Unit, UK

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. 37. Mellon SJ Grammatopoulos G Andersen MS . Optimal acetabular component orientation estimated using edge-loading and impingement risk in patients with metal-on-metal hip resurfacing arthroplasty . J Biomech 2015

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Marjan Wouthuyzen-Bakker Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands

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Levine BR Sporer SM Paprosky WG Jacobs JJ & Della Valle CJ . Do serologic and synovial tests help diagnose infection in revision hip arthroplasty with metal-on-metal bearings or corrosion? In Clinical Orthopaedics and Related Research 2015

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