Patient Activity after Total Hip Arthroplasty: A Comparison of Three Different Bearing Surfaces

Abstract

Patients who receive hip arthroplasty today desire prostheses that not only have great longevity, but are also suitable for a very active lifestyle. Advances in metallurgy, tribologic behavior, surgical technique, as well as improvements in strength and microstructure, have made ceramic-on-ceramic and metal-on-metal bearings available for young patients requiring a great deal of mobility. The purpose of this study was to assess if the bearing surface had an effect, if any, on postoperative activity levels and clinical outcomes in patients receiving three different types of hip arthroplasty. This study includes three groups of 30 patients who had each received conventional metal-on-polyethylene total hip arthroplasty (THA), ceramic-on-ceramic THA, or hip resurfacing arthroplasty. All groups were matched by men to women ratio, age, body mass index, diagnosis, preoperative activity levels, and length of follow-up. Clinical outcomes evaluated included weighted postoperative activity levels, Harris hip scores, patient satisfaction scores, revision rates, and complication rates. Patients who had received a metal-on-metal resurfacing had achieved significantly higher activity scores (mean 10.5 points; range, 1-28 points) compared to patients who had received ceramic-on-ceramic (mean 6.9 points; range, 0-34 points) or metal-on-polyethylene bearings (mean 5.6 points; range, 1-18 points). The mean postoperative Harris hip scores (94 vs 92 vs 91 points), patient satisfaction scores (9 vs 8.4 vs 8.3 points), aseptic revision (3% vs 0% vs 0%), and complication rates (3% vs 3% vs 3%) were similar between resurfacing, ceramic-on-ceramic, and metal-on-polyethylene bearing groups, respectively. This study showed that in cohorts of similarly matched arthroplasty patients in multiple demographics factors and preoperative activity levels, metal-on-metal resurfacing arthroplasty may offer higher postoperative activity levels. For patients with higher activity levels, resurfacing arthroplasty may be advantageous compared to other types of bearings.

Amount and type of physical activity and sports from one year forward after hip or knee arthroplasty—A systematic review

“…Four articles had a mean UCLA score below 5.5 points and five articles above 7.5 points. Nine articles used similar scores (Tegner activity scale, Grimby scale, Lower Extremity Activity Scale (LEAS), Sports Activity Index, Weighted Activity Score) and their results are comparable to those of the studies using the UCLA [ 34 , 36 , 44 , 56 , 84 , 100 , 114 ].…”

Patient Satisfaction Reporting After Total Hip Arthroplasty: A Systematic Review

“…The most common method for assessing satisfaction was the 10-point visual analog scale for satisfaction (7 studies, 29.2%). [20][21][22][23][24][25][26] Other methods included an ordinal scale (eg, very satisfied, satisfied, neutral, dissatisfied) (6 studies, 25.0%) [27][28][29][30][31][32] ; willingness to undergo surgery again (5 studies, 20.8%) 30,[32][33][34][35] ; and a binary scale (yes/ no for satisfied) (3 studies, 12.5%) (Table). [36][37][38] For the 3 studies reporting a binary (yes/no) result for patient satisfaction, all showed greater than 80% overall satisfaction.…”

“…Most of the studies examined satisfaction with the outcome of arthroplasty surgery (18 studies, 75.0%) 20,[22][23][24][25][26][27][28][29][30]32,[35][36][37][38][39][40][41] ; 2 studies (8.3%) examined satisfaction with cosmesis after THA 33,42 ; 3 studies (12.5%) considered satisfaction with the process of care 21,34,43 ; and 1 study evaluated satisfaction with physical therapy after THA. 31 Two studies (8.3%) measured satisfaction at multiple time points, 21,33 and the rest reported satisfaction only at 1 specific follow-up visit or at the final follow-up visit.…”

Clinical and Radiographic outcomes of the Birmingham Hip Resurfacing Arthroplasty at a Minimum follow-up of 10 Years: Results from an Independent Centre

“…Today, younger and active patients need hip replacement in an attempt to restore the lost active lifestyle. MoMHR has been introduced to increase implant longevity and optimise the functional outcomes in this challenging patient group (26, 27). The present study has shown that good results are possible by non-designer surgeons, when indications and surgical technique are strictly respected.…”