Hip resurfacing arthroplasty at a non-specialist centre

Abstract

INTRODUCTIONFew studies have reported the outcome of hip resurfacing arthroplasty (HRA) with respect to implant characteristics from non-specialist centres. We report the survival, clinical and radiological outcomes of a single surgeon series of HRA with an average follow-up duration of five years.METHODSAll consecutive HRAs performed by a single surgeon between 2003 and 2011 at a district general hospital were retrospectively examined clinically and radiologically.RESULTSA total of 85 patients underwent 109 HRAs (58 male [53.2%] and 51 female patients [46.8%]) with a mean follow-up period of 62 months (range: 12–102 months). The median age was 57 years (range: 25–75 years). The mean acetabular and femoral head component sizes were 54mm (range: 48–64mm) and 48mm (range: 42–58mm) respectively with a mean acetabular inclination angle of 42.9º (range: 20–75º).The survival rate was 95% with five revisions due to aseptic loosening (n=3) and fracture (n=2): these were predominantly for female patients (n=4), with significantly smaller mean acetabular (51mm, p=0.04) and femoral (44mm, p=0.02) implant sizes. Furthermore, they had a higher mean acetabular inclination angle of 48.1º (p=0.74). The mean Oxford hip score was 43.8 (range: 25–48) and the mean University of California Los Angeles (UCLA) activity score was 6.8 (range: 3–10). Radiological findings included heterotopic ossification in 13 (11.9%), radiolucent lines in 6 (5.5%), femoral neck thinning in 2 (1.8%) and femoral neck notching in 5 patients (4.6%).CONCLUSIONSWe have shown that HRA at a non-specialist centre has short to medium-term outcomes comparable with those at specialist centres. HRA therefore remains a viable option although vigilance is required in case selection and follow-up according to national guidance.

Revision Rate and Patient-Reported Outcome After Hip Resurfacing Arthroplasty: A Concise Follow-Up of 1064 Cases

“…The mean postoperative UCLA score value of 5.8 found in the current study was slightly below those reported by others. For example, Patel et al found a mean UCLA score of 6.8 at a mean follow-up of 62 months in a cohort of HRA patients [32], while Rahman et al reported a mean score of 7.5 after a mean follow-up of 6.6 years [33]. Whether our somewhat lower score values are attributable to different baseline characteristics, differences in follow-up time or to cross-cultural differences cannot be determined.…”

Clinical and radiographic outcomes of hip resurfacing arthroplasty after eight years – a retrospective study

“…Due to these complications, many orthopedists have abandoned the use of hip resurfacing prostheses in the last decade, 4 while a minority continues to use them due to the good short and medium-term outcomes in selected cases, such as those of male, young, and active patients with primary hip osteoarthrosis. 1 , 2 , 5 , 6 …”