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Glass molds in the 1930s. Teflon cups in the 1950s. Metal-on-metal in the 1990s. Ceramic-on-ceramic today.

A 2026 review in HIP International traces a century of hip resurfacing and what each generation taught surgeons.

Review cover on a century of hip resurfacing, with a stylised implant illustration.
Timeline of hip resurfacing implant designs, complications and surgical technique lessons.
Summary of metal-on-metal resurfacing outcomes, registry survival, risks and patient exclusions.
ReCerf® implant graphic and reported five-year survival: 98% overall, with sex and head-size subgroups.
Summary of hip resurfacing priorities: long-term evidence, surgical training and planning tools.

Dr. Joshua Filer and Richard P Baker (Avon Orthopaedic Centre, Bristol) conclude that implant design, patient selection, and surgeon experience are critical to long-term clinical success.

 

According to the review, concerns about metal-on-metal bearings contributed to a fall in resurfacing from 10.3% of UK primary hip procedures in 2006 to 0.6% in 2023.

 

Today’s hybrid metal-on-metal systems perform well in a defined group: young, active men with femoral heads ≤50 mm. UK National Joint Registry 10-year cumulative revision rates are 7.06% for Birmingham Hip Resurfacing (BHR) and 7.67% for Adept®.

 

The authors note that women and patients with smaller head sizes and/or metal sensitivity remain largely excluded, mainly because of the risk of femoral neck fracture, a higher risk of adverse reactions to metal debris (AMRD), and concerns regarding metal ion toxicity.

 

They point to ceramic-on-ceramic resurfacing as one way forward. ReCerf® (MatOrtho Ltd) and H1® (Embody Orthopaedic) hip resurfacing implants both use BIOLOX®delta ceramic technology. 

 

The ReCerf® data cited in the review are derived from an international multicenter retrospective study (Koh et al., 2025), with 98% survival at 5 years, comparable between men (97.6%) and women (98.5%) and between larger heads ≥50 mm (98.5%) and smaller heads ≤ 50 mm (97.5%). 

 

According to the authors, these results allow indications for hip resurfacing arthroplasty (HRA) to expand to women and patients needing smaller head sizes. They also emphasize the need for longer-term studies, acknowledge the technical demands of HRA, and highlight the importance of adequate surgeon training.

 

References:
Filer J, Baker RP. Hip resurfacing: a narrative review of the past, present and future. HIP Int. Published online August 9, 2026. doi:10.1177/11207000261467907.
Koh CK, Walter WL, Yates P, et al. Influence of head size and sex on the five-year survival of ceramic-on-ceramic hip  resurfacing: an international multicentre study. Bone Joint J. 2025; 107-B: 691–697.

 

Please check for regulatory approval in your country.

This post reflects CeramTec’s summary of a peer-reviewed scientific publication and does not constitute clinical guidance, risk prediction for individual patients, or product-related recommendations. For product, safety, and risk information, always refer to the labeling of the legal manufacturer.

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