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Background: Aseptic loosening of hip prostheses may lead to implant failure and necessitate revision surgery. Metal-on-metal hip articulation has characteristics that may minimize prosthesis loosening when compared with other forms of hip articulation. The purpose of the present prospective study was to identify early problems that may contraindicate the use of the 'prosthesis femorale modulaire' (PFM) metal-on-metal prosthesis. Methods: The preliminary results of 57 metal-on-metal total hip arthroplasties performed by one surgeon (RR) from 1994 to 1996 in Lismore, New South Wales, are presented here. Data were obtained using patient questionnaires, physical examination and by examination of radiographs. Results: A total of 87.6% of patients had an excellent or good outcome, according to the Harris rating system, at the latest review. The two patients with poor results had obvious alternative causes for their continuing symptoms. There was no radiological evidence of bone or prosthesis failure during the period of follow-up. Conclusions: The preliminary results are comparable with those of other authors who have examined the early results of metal-on-metal total hip arthroplasty.

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