High failure rate of the R3 metal-on-metal total hip arthroplasty

We report our failures with the use of the R3 metal-on-metal bearing. Forty six patients had an R3 acetabular system metal-on-metal THR in our centre between March 2007 and March 2009. All operations were performed using femoral components and appropriately matched femoral heads manufactured by Smith & Nephew. Twelve patients underwent revision surgery for adverse reaction to metal debris (ARMD). The median acetabular inclination was 40 degrees (range 21.1-49.1) and the median acetabular anteversion was 7.5 degrees (range 3.3-10.4). The median serum Cobalt was 9.9 µg/L (range 3.1-45) and the median serum Chromium was 5.8 µg/L (range 1.8-19.3). The time to revision was 39.2 months (range 13-53). Our current failure rate is 24%.