Resurfacing and Uncemented Arthroplasty for Young Hip Arthritis: Functional Outcomes at 5 Years

Abstract

The management of osteoarthritis of the hip in young active patients is challenging. We compared the functional outcomes and activity levels following hip resurfacing and uncemented THA in young active patients matched for age, gender and activity levels. Mean follow-up period was five years (4-7 years). Within each group there was a statistically significant improvement in the mean University of California at Los Angeles (UCLA) and Oxford Hip Score (OHS) scores following surgery. This study found no statistically significant difference in the levels of function (p= 0.82) or activity pursued (p= 0.60) after surgery between uncemented THA and hip resurfacing. The potential complications unique to hip resurfacing may be avoided by the use of uncemented THA which in itself has longer follow-up compared to resurfacing.

Patients Report Improvement in Quality of Life and Satisfaction After Hip Resurfacing Arthroplasty

“…Our assessment of generic QoL (SF-12) demonstrated improvements on the physical and mental component scores comparable to the nonarthritic population. These outcomes support and underscore recent reports on WOMAC scores [25,38,39,41,57,59,69,70] and Oxford Hip Scores [31,36,[56][57][58] from other authors and patient populations. Our SF-12 results are in agreement with published SF-12 and SF-36 outcomes, which demonstrate restoration of generic QoL approaching that of the normal population [16,41,56,58] (Table 4).…”

What is the Midterm Survivorship and Function After Hip Resurfacing?

“…However, Marker et al [35] reported similar functional hip scores and radiographic assessment in a recent review of the literature comparing hip resurfacing with THA, although a number of studies included in the review did show better clinical outcomes after hip resurfacing [35]. In addition to this, Killampalli et al [27] reported no differences in functional scores in young patients treated with hip resurfacing compared with THA at a minimum 5-year followup. Despite this, hip resurfacing as an alternative to conventional THA does offer a number of advantages: preservation of the metaphyseal and diaphyseal femoral bone; improved radiographic biomechanical parameters of the hip e.g.…”

Recent Clinical Evidence for the Treatment of Osteoarthritis: What we have Learned

“…Hip resurfacing remains a successful implant in relatively young males with normal anatomy, but in other patient groups popularity with surgeons has reduced dramatically. Even in the young male group there is no demonstrable superiority in terms of function or longevity when compared to traditional hip replacements [128]. Other conservative hip replacements are in development, but at this stage must be regarded as experimental.…”