Smith & Nephew, Inc. announced that it has introduced the metal liner option for its R3 Acetabular System which is an advanced multi-bearing acetabular cup system used in hip replacement and resurfacing procedures. The FDA recently approved metal liner for use with the BIRMINGHAM HIP Resurfacing (BHR) System. R3 system was previously fitted with cross-linked polyethylene (XLPE) liners for use in total hip replacement cases, and this week the company received FDA approval of its ceramic liner option. This acetabular system is the first of its kind available to surgeons that accommodates the major advanced bearing options, including metal-on-metal, ceramic-on-ceramic, cobalt chrome on cross- linked polyethylene (XLPE), and the company's exclusive OXINIUM Oxidized Zirconium on XLPE. In addition to providing intraoperative flexibility for surgeons, the multi-bearing cup provides solutions designed to reduce wear and the subsequent need for revision surgery. It is optimized to help the R3 system achieve joint stability and a greater range of motion and its range of inserts accommodates larger head sizes. The R3 Acetabular System gives surgeons simplicity in the operating room and confidence in a stable, multi-bearing system by utilizing disposable trial liners and a single set of instruments for all bearings. A higher coefficient of friction than trabecular metal on both cancellous and cortical bone was demonstrated by the R3 Acetabular System's proprietary STIKTITE porous coating, indicating the potential for superior scratch-fit feel and initial fixation. Also the system is enhanced by a proprietary hard-bearing alignment guide, which is a thin plastic shield resembling a disposable coffee cup lid that enables surgeons to simply and accurately place a ceramic or metal liner into the shell during surgery. The risk of improper seating and malalignment seen in other systems is reduced by straightforward technique.