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Total hip replacement (THR), one of the most successful and cost effective surgical interventions introduced in the last 50 or so years in medicine and the second most common elective operation in the UK (Sheldon et al., 1996, Garellick et al., 1998), owes most of its success to the introduction of hard-on-soft arthroplasty by Charnley. Arthroplasty (from the Greek ‘arthrosis’ = ‘joint’ and ‘-plasty’ = ‘the making of’) describes the surgical reconstruction or replacement of a malformed, degenerated or traumatised joint. THR is the treatment of choice for conditions that affect both the articular surfaces (i.e. acetabulum and femur) of the hip joint. Worldwide, approximately one million artificial hips are implanted annually (Smith & Learmonth, 1996). Problems with polyethylene (PE) wear debris from soft-on-hard articulations (causing an infiltration of macrophages, eventually leading to destruction of bone and soft tissue and initiating loosening of the implant) led to the development of hard-on-hard bearing combinations for artificial hips as the latter produce minimal wear and therefore implant failure is delayed.

The Genotoxic Potential of Novel Materials Used in Modern Hip Replacements for Young Patients