High Revision Rate at 5 Years after Hip Resurfacing with the Durom Implant

Abstract

Background/rationale There is growing evidence that different resurfacing implants are associated with variable survival and revision rates. A registry analysis indicated the Durom resurfacing implant had high revision rates at 5 years, whereas three original studies reported low revision rates at short-term followups. Thus, the revision rates appear controversial. Questions/purposes We therefore assessed (1) the survivorship including differences between women and men at a mean of 5 years after resurfacing with the Durom implant, and (2) clinical scores and radiographic parameters. Patients and Methods We prospectively followed all 100 Durom hip resurfacings implanted in 91 patients (25 women and 66 men; mean age, 52 years) between 2003 and 2004. Survivorship analysis was performed with pending revision or revision for any reason as the endpoint. The minimum followup was 47 months (mean, 60 months; range, 47-72 months).Results At a mean of 5 years, 11 hips were revised for various reasons. Cumulative survival was 88.2% for all patients and 81.5% for women. The mean Oxford (OHS) and Harris hip (HHS) scores were 14.6 and 94.7, respectively. The mean UCLA activity level was 7.9. Sclerotic changes around the short femoral stem (pedestal sign) were detected in 40% of the hips. We observed considerable femoral neck thinning with component-to-neck ratios of 0.85 preoperatively and 0.82 at 5 years. Conclusions Our study highlights a high revision rate 5 years after hip resurfacing with the Durom implant. This observation underlines previous findings from registry data and suggests that revision rates increase with time.

Durom hip resurfacing system: Retrospective study of 644 cases with an average follow-up of 34 months

“…Thus it seems that for a young population, the survival rate for a resurfacing implant is very close to that of a traditional THA, which is consistent with data from our series (5-year rate between 90 and 100%, depending on the centre). But this rate was worse because of complications specific to the Durom implant, such as early implant tilting [27], which was observed in 1% of cases with this same implant [34]. This occurred more often than with the Birmingham hip resurfacing system because the bone ingrowth is not as good [27].…”

The Canadian Arthroplasty Society’s experience with hip resurfacing arthroplasty

“…1,20 Inferior results with specific implant systems have also been shown in various studies. 3,7,[30][31][32][33] Higher rates of failure were noted with the ASR, Durom and Cormet systems. Our study was not designed specifically to compare the systems, but appears to be in keeping with the published global experience.…”

“…5 Several studies have reported successful mid-term survival rates for four different resurfacing systems: Birmingham Hip Resurfacing (BHR; Smith & Nephew, Memphis, Tennessee), 12,[21][22][23][24] Cormet 2000 (Corin, Tampa, Florida), 25,26 Conserve Plus (Wright Medical Technologies, Memphis, Tennessee) 27,28 and the Recap-Magnum (Biomet, Warsaw, Indiana). 29 Two other hip resurfacing systems, the Durom (Zimmer, Warsaw, Indiana) 30,31 and the Articular Surface Replacement (ASR) (DePuy, Warsaw, Indiana), 7,32,33 have been recalled owing to unacceptable design-related failure rates.…”

What Are the Risks Accompanying the Reduced Wear Benefit of Low-clearance Hip Resurfacing?

“…A recent study [32] of the Durom 1 resurfacing system reported a 17% revision rate in women and 9% in men at a mean followup of 5 years, of which more than 1 .…”

“…Recently high failure rates have been reported with certain metal-metal (MM) hip resurfacing implants [4,22,32]. However, well-designed and properly positioned hip resurfacing implants continue to show 96% to 98% survival The institution of one or more of the authors (JD, CP, HZ, DM) has received funding from Smith & Nephew Orthopaedics UK Ltd (Warwick, UK).…”