An analysis of more than 400 000 hip replacement operations carried out in England and Wales since 2003 has called into question the value of resurfacing after it was found that this type of procedure is more likely to fail within five years than a total hip replacement.

The likelihood of needing a second operation is especially high among women, but revision rates after resurfacing are also raised in those men who have smaller devices fitted, show the findings.1 Resurfacing should be avoided in both these groups of patients, say the authors.

In February a joint investigation by the BMJ and the BBC's Newsnight programme found that metal on metal devices had a failure rate of 11.8% for resurfacing and 13.6% for total hip replacements after seven years, much higher than the 3.3% to 4.9% for hip implants made of other materials.2 The findings, which were based on data from the …