Adept Hip Resurfacing Implant Birmingham

What it is

A Cobalt-Chromium Cap, Refined Over Two Decades

The Adept hip resurfacing system is the bearing that quietly carries the longest mainstream registry record of any device still in active routine use. Manufactured in the United Kingdom by MatOrtho, it is built from as-cast high-carbon cobalt-chromium and finished to the tight tolerances on which the durability of a metal-on-metal resurfacing depends.

Adept metal-on-metal hip resurfacing implant by MatOrtho, photographed on a navy background

The Adept femoral cap and acetabular cup, photographed against the same navy background used on the home page hero.

The femoral component is a thin cap that reshapes the worn surface of the femoral head without resecting it. The acetabular component is a press-fit cup with a hydroxyapatite coating that encourages bony ingrowth and biological fixation, with no requirement for screws in the great majority of patients. The bearing is metal-on-metal: the same cap-on-cup geometry that defined the modern resurfacing operation when it was developed in Birmingham in the 1990s, and that, in carefully selected patients, has continued to deliver excellent long-term results.

Key facts

Bearing: Metal-on-metal cobalt-chromium
Manufacturer: MatOrtho (Leatherhead, UK)
ODEP rating: 15A in men, 48 to 58 mm heads
First implanted: 2004

Who it suits

The Patient Profile the Data Supports

Adept is offered today to a defined group of patients: active men with larger native femoral heads, where the long-term data on metal-on-metal resurfacing is unambiguously strong. Indications and contraindications below are the working framework, settled in clinic on the basis of imaging, examination and a frank conversation about activity, life expectancy and tolerance for surveillance.

Indicated for

Men with end-stage hip osteoarthritis and good bone quality.
Native femoral heads in the 48 to 58 mm range, where the ODEP 15A rating applies.
Active lifestyles with a clear wish to return to higher-impact activities.
Patients who value the longest available track record over the newest bearing chemistry.
Patients comfortable with lifelong cobalt and chromium ion surveillance under MHRA guidance.

Not appropriate for

Women and patients of child-bearing potential. Ceramic-on-ceramic implants are offered in this group; metal-on-metal is not.
Smaller native femoral heads (below 48 mm), where smaller bearings have a meaningfully worse historic profile.
Osteoporotic, cystic or otherwise compromised femoral head bone, where avascular necrosis risk is elevated for any resurfacing.
Known cobalt or chromium hypersensitivity.
Severe renal impairment, where ion clearance is reduced.

For the patient who fits the profile, Adept is a confident, evidence-led choice. For the patient who does not, the ceramic options are now real and excellent. The clinic conversation is the right place to settle which is which.

Track record

Twenty Years on the National Joint Registry

The Adept system entered routine use in 2004 and has been tracked in the National Joint Registry of England, Wales, Northern Ireland and the Isle of Man since shortly thereafter. Long-term published outcomes in the well-selected male patient with a larger native head are consistently among the best for any hip arthroplasty, with low revision rates that compare favourably with stemmed total hip replacement at matched follow-up.

What ODEP 15A means

The Orthopaedic Data Evaluation Panel (ODEP) rating system grades hip and knee implants on the strength of their long-term outcomes data. A 15A rating means the implant has at least fifteen years of clinical follow-up with a strong evidence base. Adept holds ODEP 15A in men with 48 to 58 mm heads, which is to say: a documented fifteen-year record in the specific patient profile in whom it is used today.

Reading the wider metal-on-metal data honestly

The decade between 2008 and 2018 saw considerable turbulence in metal-on-metal hip surgery. Several devices, most prominently the DePuy ASR, were withdrawn after independent data revealed unacceptable revision rates, and the MHRA issued repeated alerts that broadened the pool of patients requiring formal surveillance. The dominant risk factors were small bearing diameter, smaller native head size, sub-optimal cup positioning and lower-volume surgeons. Adept used today, in the patient profile its data supports and at the volumes of a specialist centre, sits well outside that risk envelope. The surveillance pathway remains lifelong, which is part of choosing this bearing knowingly.

Metallosis: What It Is, and How It Is Monitored

A dedicated page explains the body's response to metal debris from metal-on-metal bearings, the MHRA surveillance pathway, and what the lifelong follow-up actually looks like for patients with an Adept implant.

Where Adept Sits Alongside ReCerf and H1

The introduction of ceramic-on-ceramic resurfacing has not displaced Adept. It has clarified what Adept is for. The conversation in clinic is no longer about which bearing to use by default, but about which bearing best fits the individual hip in front of us. Adept's place in that conversation is precise.

Where the patient profile matches the ODEP-rated indication, and where the patient prefers the longest documented track record on offer, Adept is the strongest evidence-led choice. Where the patient is female, of child-bearing potential, smaller-framed, or simply prefers a bearing chemistry that requires no metal-ion surveillance, the ceramic options are the answer.

Ceramic-on-ceramic

ReCerf

The all-ceramic successor to Adept, built by MatOrtho on the same geometry. CE marked 2024 with multicentre five-year outcomes published.

ReCerf detail →

Ceramic-on-ceramic

H1

The British ceramic resurfacing developed at Imperial College London and made by Embody. A newer ceramic option in the field.

H1 detail →

Questions

Questions Patients Ask About Adept

Why is Adept still used when ceramic alternatives now exist?

Adept retains the longest mainstream registry record of any hip resurfacing system in current routine use. For active men with larger native femoral heads, the long-term data is excellent, and the bearing choice is supported by years of follow-up that ceramic systems have not yet had time to accumulate. For this defined patient profile, the certainty of long-term outcomes is a real clinical advantage.

Is metal-on-metal hip resurfacing safe in 2026?

When the bearing is matched to the right patient and the surgery is performed at a high-volume centre, modern metal-on-metal resurfacing is safe and durable. The problems of the late 2000s and early 2010s were concentrated in smaller bearing diameters, smaller native heads, sub-optimal cup positioning and lower-volume surgeons. Adept used today, in the patient profile its data supports, sits well outside that risk envelope.

What does long-term follow-up look like with Adept?

Patients with any metal-on-metal hip remain on lifelong surveillance under MHRA guidance. This typically means annual clinical review with imaging where indicated, and periodic blood cobalt and chromium ion measurement. Most patients have stable, low ion levels and no clinical concern. Where ion levels rise or symptoms develop, the surveillance pathway is well established.

What is metallosis, and does Adept cause it?

Metallosis is the body's reaction to fine metal debris released by a metal-on-metal hip bearing. It is the family of problems that drove the difficult years of the late 2000s. The risk is real but is concentrated in specific circumstances: smaller bearings, smaller native heads and poorly positioned components. A dedicated metallosis page explains what it is, how it is monitored, and why it matters less for the patient profile in whom Adept is used today.

Would I be advised against Adept if I were a younger woman?

Yes. Women and patients of child-bearing potential are not offered metal-on-metal resurfacing in this practice. The ceramic-on-ceramic implants, ReCerf and H1, are the appropriate options for these patients and have changed candidacy meaningfully. A dedicated page covers hip resurfacing for women in detail.

Next Step

Discuss Adept in Clinic

A private consultation with weight-bearing imaging is the most useful next step. We will tell you, on your own anatomy, whether Adept is the right bearing or whether a ceramic option suits your hip and your life better.

Book a Consultation