Patient-reported outcomes in hip resurfacing versus conventional total hip arthroplasty: a register-based matched cohort study of 726 patients

Abstract

Background and purpose — The theoretical mechanical advantages of metal-on-metal hip resurfacing (MoM-HR) compared with conventional total hip arthroplasty (THA) have been questioned. Studies including measures of patient-reported function, physical activity, or health-related quality of life have been sparse. We compared patient-reported outcomes in MoM-HR patients with a matched group of patients with conventional THA at 7 years post-surgery. Patients and methods — Patients and patient data were retrieved from the Swedish Hip Arthroplasty Register. The case group, consisting of 363 patients with MoM-HR, was matched 1:1 with a control group, consisting of patients with a conventional THA. Patients were sent a postal patient-reported outcome measures (PROM) questionnaire including the Hip Disability and Osteoarthritis Outcome Score (HOOS), EQ-5D, and VAS pain. We used multivariable linear regression analyses to investigate the influence of prosthesis type. Results — 569 patients (78%) returned the questionnaire with complete responses (299 MoM-HRs and 270 conventional THAs). MoM-HR was associated with better scores in HOOS function of daily living (4 percentage units) and HOOS function in sport and recreation (8 percentage units) subscales. Type of prosthesis did not influence HOOS quality of life, HOOS pain, HOOS symptoms, EQ-5D index, hip pain, or satisfaction as measured with visual analog scales. Interpretation — At mean 7 years post-surgery, patients with hip resurfacing had somewhat better self-reported hip function than patients with conventional THA. The largest difference between groups was seen in the presumed most demanding subscale, i.e., function in sport and recreation.

Patients with hip resurfacing arthroplasty are not physically more active than those with a stemmed total hip

“…A 20-points mean difference was seen in the HOOS-PS in favor of HRA. This is in accordance with a recent publication of Oxblom et al ( 2019 ). They studied 726 subjects 7 years after primary HRA or conventional THA showing a significant difference in HOOS subscales of function of daily living and function in sport and recreation, although HOOS subscales of symptoms, pain, and quality of life, EQ-5D index, and visual analog scores for pain and satisfaction did not differ.…”

Trends and developments in hip and knee arthroplasty technology

“…19 There is presently some suggestion that dual mobility articulations should be offered as a mainstream alternative to more traditional articulations. 20 Given the advantageous and well-established increase in stability associated with a dual mobility articulation, 4,5 the trend for increased utilisation of the technology may be related to increasing recognition of the relevance of unfavourable spinopelvic mobility and its implications in the stability of total hip arthroplasty. There has also been growth of their use in high risk groups such as those with neuromuscular conditions or cognitive impairment.…”

No Clinically Meaningful Differences in 1-Year Patient-Reported Outcome Measures between Hip Resurfacing and Total Hip Arthroplasty: An Age-Matched Prospective Cohort Study

“…The present study was in accordance, and no statistically significant differences were observed in HOOS Pain or HOOS-PS between HR and THA at 1-year follow-up. An Oxblom et al study 20 differed from the rest: statistically higher HOOS ADL and sports and recreation subscales were observed in the HR group. This was a retrospective review of 299 HRs compared with 270 THAs at a mean follow-up of 7 years.…”