Metal-On-Metal Hip Resurfacing in Patients Aged 65 Or Older

Duff, Michel J. Le; Takamura, Kohtaroh B.; Amstutz, Harlan C.

doi:10.5301/hip.2012.10350

Cited by 6 publications

(14 citation statements)

References 34 publications

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“…Findings demonstrate good survival and functional outcomes with the BHR in both male and female patients ≥65 at up to ten years of follow up. Overall ten year BHR survival was 96.4 %, which is comparable with that reported in a smaller designer-surgeon series (96.7 %) using a different hip resurfacing implant in elderly patients (Table 3) [21]. In addition, the ten year survival for men (98.9 %) and women (91.9 %) was not significantly different, with survival for both genders within acceptable limits recommended by the National Institute for Health and Clinical Excellence (NICE) (revision rate ≤10 % at ten years for continued use of an implant) [33].…”

Section: Discussionsupporting

confidence: 77%

“…Findings presented here support this observation, with an OHS (median 4.4 %) similar to that in patients up to 50 years of age undergoing BHR by the same surgeon (median OHS 4.2 %) [36]. A recent nonmatched study of patients undergoing hip resurfacing and THR demonstrated significantly better postoperative pain, function and activity scores in the resurfacing group [21]. Although there was no matched patient group undergoing THR for this study, the functional outcome in elderly BHR patients (median OHS 4.4 %) represents a clinically significant difference compared with our institution's historic results following THR (median OHS 20.8 %) [24].…”

Section: Discussionsupporting

confidence: 75%

“…In the study reported here, functional outcome following BHR assessed using the OHS was excellent with most elderly patients being almost completely asymptomatic (median OHS 4.4 %; 25th percentile scoring 0 %). Similar functional outcomes are reported following hip resurfacing in elderly patients [19][20][21]. Two studies demonstrated elderly patients undergoing hip resurfacing achieved good to excellent functional outcomes comparable with younger patients [19,20], with the latter study observing no difference in functional recovery rates between groups at up to one year [20].…”

Section: Discussionsupporting

confidence: 59%

“…However, only a few studies have reported specifically on elderly patients undergoing hip resurfacing. These studies demonstrate good outcomes may be achieved in older patients, comparable with younger individuals undergoing the same procedure [19][20][21].…”

Section: Introductionmentioning

confidence: 76%

“…≥65) [19][20][21]. This series represents the largest elderly patient cohort undergoing hip resurfacing reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

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Survival and functional outcome of the Birmingham Hip Resurfacing system in patients aged 65 and older at up to ten years of follow-up

Pailhé

Matharu

Sharma

et al. 2013

International Orthopaedics (SICOT)

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Purpose Limited evidence exists regarding the outcomes of hip resurfacing in elderly patients. The primary study aims were to determine the survival and functional outcome following Birmingham Hip Resurfacing (BHR) in patients ≥65 years at up to ten years of follow-up. Secondary aims were to explore factors affecting survival and functional outcome. Methods Between 1997 and 2012, data were prospectively collected on 180 BHR (162 patients; mean age 69.2 years; 62 % male) implanted by one designing surgeon. Mean follow-up was six (range one to 14.4) years with no loss to follow-up. Outcomes of interest were implant survival, functional outcome [Oxford Hip Score (OHS)] and radiological evidence of implant failure. Results Three hips were revised, giving an overall cumulative survival of 96.4 % [95 % confidence interval (CI) 90.3-100] at ten years. Survival of 111 male BHR was 98.9 % (95 % CI 94.8-100) at ten years (one revision) compared with 91.9 % (95 % CI 77.0-100) in 69 female BHR (two revisions). Survival was affected by age (p=0.014) and femoral head size (p=0.024) but not by gender (p=0.079). Median pre-operative OHS was 50.0 % [interquartile range (IQR) 37.5-68.8], improving to 4.4 % (IQR 0-10.4) postoperatively. Men had significantly better postoperative OHSs compared with women (median male OHS 2.1 % versus 6.3 % female OHS; p=0.021). Conclusions Good survival and functional outcomes were achieved with the BHR at ten years in men and women ≥65 years. Despite registry findings to the contrary, age alone should not be a contraindication for hip resurfacing in centres with expertise in this procedure.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionsupporting

confidence: 75%

Section: Discussionsupporting

confidence: 59%

Section: Introductionmentioning

confidence: 76%

“…≥65) [19][20][21]. This series represents the largest elderly patient cohort undergoing hip resurfacing reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Survival and functional outcome of the Birmingham Hip Resurfacing system in patients aged 65 and older at up to ten years of follow-up

Pailhé

Matharu

Sharma

et al. 2013

International Orthopaedics (SICOT)

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Current indications for hip resurfacing arthroplasty in 2016

Sershon

Balkissoon

Valle

2016

Curr Rev Musculoskelet Med

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Hip resurfacing arthroplasty (HRA) is an alternative to conventional, stemmed total hip arthroplasty (THA). The best reported results are young, active patients with good bone stock and a diagnosis of osteoarthritis. Since the 1990s, metal-on-metal (MoM) HRA has achieved excellent outcomes when used in the appropriate patient population. Concerns regarding the metal-on-metal bearing surface including adverse local tissue reaction (ALTR) to metal debris have recently lead to a decline in the use of this construct. The current paper aims to provide an updated review on HRA, including a critical review of the most recent literature on HRA.

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Long-term results of metal-on-metal hip resurfacing in patients 65 years of age or older

Amstutz¹,

Duff²

2020

HIP International

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Background: Metal-on-metal hip resurfacing arthroplasty (MMHRA) is typically used in young and active patients because they have the most to gain from this bone-preserving procedure. However, there is very little long-term data on the performance of MMHRA in patients 65 years of age or older because of the efficacy of conventional total hip arthroplasty in this patient population. Methods: 109 patients (124 hips) age ⩾65 years were treated with Conserve Plus MMHRA. There were 83 male and 26 female patients. Their mean age at surgery was 69.5 (range 65–83) years. UCLA hip scores, SF-12 quality of life score were collected at follow-up visits. Radiographic and survivorship analyses were performed. Results: SF-12 scores and UCLA scores were maintained over time except for a small decrease in activity. 4 patients underwent revision surgery. The 15-year Kaplan-Meier survivorship of the cohort was 93.7%. All revisions surgeries were successful at a mean follow-up time of 113 (range 30–218) months. Unusual radiographic findings from our previous publication did not progress over time except for 1 hip that showed a complete radiolucency around the acetabular component. Conclusions: Our results clearly show that HRA is a viable prosthetic solution with many advantages for all active patients, regardless of their age at the time of surgery.

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Metal-On-Metal Hip Resurfacing in Patients Aged 65 Or Older

Cited by 6 publications

References 34 publications

Survival and functional outcome of the Birmingham Hip Resurfacing system in patients aged 65 and older at up to ten years of follow-up

Survival and functional outcome of the Birmingham Hip Resurfacing system in patients aged 65 and older at up to ten years of follow-up

Current indications for hip resurfacing arthroplasty in 2016

Long-term results of metal-on-metal hip resurfacing in patients 65 years of age or older

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