Metal on Metal Articulation in Total Hip Replacement

  • P. Roberts
  • P. Grigoris


The history of metal on metal articulation began at the Middlesex Hospital in London in 1938. Philip Wiles carried out total hip replacements in six patients with Stil’s disease [1]. The acetabular and femoral components were made of stainless steel and were ground together to ensure an accurate fit. The cup was fixed with two screws and the femoral component was secured by a bolt inserted down the femoral neck, attached to a plate on the lateral aspect of the femur (Fig. 11.1). Unfortunately all the radiographs were lost during the Second World War. Only one patient, with a disintegrated prosthesis, was still alive in 1951. In 1957 Wiles developed another design with better engineering and a more robust method of fixation. He performed eight operations, but the results were disappointing because of bone resorption and prosthetic loosening.


Wear Rate Femoral Component Acetabular Component Frictional Torque Metal Articulation 
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© Springer-Verlag London 2000

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  • P. Roberts
  • P. Grigoris

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