There is little information regarding the clinical performance of hip resurfacing arthroplasty (HRA) in older patients. Eighty-seven patients (99 hips) aged 65 years or older received HRA while a control group of 52 patients (64 hips) received a primary THA. The average age was 69.2 years for the HRA group and 71.9 years for the THA group. Follow-up ranged from 2 to 13 years. UCLA walking, function and activity scores and SF-12 scores were higher in the HRA group. At 10 years, the Kaplan-Meier overall survivorship rates were 96.7% for the HRA group and 91.2% for the THA group (p = 0.3174). We suggest considering hip resurfacing for patients 65 or older in centres where there is expertise in performing this procedure.

ABSTRACT:The theoretical advantage of using thinner acetabular components in hip resurfacing has not yet been clinically verified. Our purpose was to test the hypothesis of bone conservation and assess the effects of using a thinner acetabular component on hip biomechanics and clinical outcome. We compared the bone conservation, biomechanical results, and functional outcomes between hips in 35 patients who received bilateral metal-on-metal resurfacing arthroplasties with acetabular components of 5 mm thickness on one side and 3.5 mm thickness on the other. Acetabular abduction angle and acetabular anteversion were measured using Ein-Bild-Röentgen-Analysis software. Medial acetabular wall thickness and position of the hip center of rotation were measured using Image J software. The change in position of the hip center of rotation was minimal and did not reach significance. Thin-shelled components showed greater bone conservation on the acetabular side measured by an increase in the medial acetabular wall thickness. Bone conservation on the femoral side was achieved as well with thin shells. Range of motion, pain scores, and complication rates were comparable. No appreciable difference was found in bone-cup radiographic appearance between the two types of components. These data suggest that patients can experience good clinical outcomes for resurfacing with either thin or thick-shelled acetabular components. However, thin-shelled components preserve acetabular bone stock and allow the use of a larger femoral component. The use of thinner acetabular components is an improvement in bone conservation for a hip resurfacing design.