 Recent studies have shown that metal on metal hip replacements and resurfacings are associated with higher revision rates than other types of implants. These findings have prompted further investigation into the potential causes of this phenomenon. One possible explanation for the increased risk of failure is the release of metal particles from the implant, which can lead to inflammation and tissue damage. In addition, some patients may experience no symptoms despite having an adverse reaction to metal debris. Therefore, it is important for healthcare professionals to remain alert and conduct thorough follow-up exams to identify any signs of implant failure. This article was authored by James Drummond, Fong Tran, and Candon Ferry.