Hip resurfacing arthroplasty and total hip arthroplasty in the same patient: which do they prefer?

2019 ◽  
pp. 112070001988292 ◽  
Author(s):  
Tyler E Calkins ◽  
Linda I Suleiman ◽  
Chris Culvern ◽  
Sulaiman Alazzawi ◽  
Gregory S Kazarian ◽  
...  

Introduction: Hip resurfacing arthroplasty (HRA) is an alternative to conventional total hip arthroplasty (THA) with potential advantages of preserving femoral bone stock and the ability to participate in higher impact activities. This study compares outcomes, satisfaction and preference in patients who underwent HRA in 1 hip and THA on the contralateral side. Methods: 62 Patients with an HRA in 1 hip and a contralateral THA were retrospectively identified at 3 centres, consisting of 38 males and 24 females with 53 patients (85.5%) undergoing HRA first. A survey regarding satisfaction and preference for each procedure and outcome scores were obtained. Results: Patients were younger (51.5 vs. 56.6 years, p = 0.002) and had longer follow-up on the HRA hip (11.0 vs. 6.0 years, p < 0.001). HRA was associated with larger increase in Harris Hip Score from preoperative to final follow-up (35.8 vs. 30.6, p = 0.035). 18 Patients (29.0%) preferred HRA, 19 (30.6%) preferred THA and 25 (40.3%) had no preference ( p = 0.844). When asked what they would choose if they could only have 1 surgery again, 41 (66.1%, p < 0.001) picked HRA. Overall satisfaction ( p = 0.504), willingness to live with their HRA versus THA for the rest of their life ( p = 0.295) and recommendation to others ( p = 0.097) were similar. Conclusions: Although HRA is associated with risks related to metal-on-metal bearings, it showed greater increase in patient-reported outcomes and a small subjective preference amongst patients who have undergone both conventional and resurfacing arthroplasty.

2018 ◽  
Vol 107 (2) ◽  
pp. 180-186
Author(s):  
S. S. A. Miettinen ◽  
T. J. Mäkinen ◽  
K. Mäkelä ◽  
H. Huhtala ◽  
J. S. Kettunen ◽  
...  

Background and Aims: Large-diameter head total hip arthroplasty and hip resurfacing arthroplasty were popular in Finland from 2000 to 2012 for the treatment of hip osteoarthritis. The aim of this retrospective study was to investigate the mid-term survival of large-diameter head total hip arthroplasty patients operated on in three university hospitals and to compare these results to the survival of hip resurfacing arthroplasty patients. Material and Methods: A total of 3860 hip arthroplasties (3029 large-diameter head total hip arthroplasties in 2734 patients and 831 hip resurfacing arthroplasties in 757 patients) were operated on between January 2004 and December 2009. The mean follow-up was 4.3 years (range: 0.3–8.0 years) in the total hip arthroplasty group and 5.1 years (range: 1.7–7.9 years) in the hip resurfacing arthroplasty group. Cox multiple regression model and Kaplan–Meier survival analysis were used to study the survival of the total hip arthroplasties and the hip resurfacing arthroplasties. Intraoperative complications and reasons for revisions were also evaluated. Results: In Cox regression analysis, the hazard ratio for revision of hip resurfacing arthroplasty was 1.5 compared with large-diameter head total hip arthroplasty (95% confidence interval: 1.0–2.2) ( p = 0.029). The cumulative Kaplan–Meier survival rate was 90.7% at 7.7 years for the large-diameter head total hip arthroplasty (95% confidence interval: 86.8–94.6) and 92.2% at 7.6 years for hip resurfacing arthroplasty (95% confidence interval: 89.9–94.6). There were a total of 166/3029 (5.5%) intraoperative complications in the large-diameter head total hip arthroplasty group and 20/831 (2.4%) in the hip resurfacing arthroplasty group ( p = 0.001). Revision for any reason was performed on 137/3029 (4.5%) of the arthroplasties in the large-diameter head total hip arthroplasty group and 52/831 (6.3%) in the hip resurfacing arthroplasty group ( p = 0.04). Conclusion: The mid-term survival of both of these devices was poor, and revisions due to adverse reactions to metal debris will most likely rise at longer follow-up. There were more intraoperative complications in the large-diameter head total hip arthroplasty group than in the hip resurfacing arthroplasty group.


2013 ◽  
Vol 5 (3) ◽  
pp. 20 ◽  
Author(s):  
Régis Pailhé ◽  
Nicolas Reina ◽  
Etienne Cavaignac ◽  
Akash Sharma ◽  
Valérie Lafontan ◽  
...  

There is a need of independent prospective studies about modern generation of hip resurfacing implants. The aim of this propective observational study was to compare the functional outcomes and revision rates with hip resurfacing arthroplasty and total hip arthroplasty and to present the preliminary results at 2 years. Patients included were recruited prospectively in the <em>Partial Pelvic Replacement Hip Project </em>by a single surgeon between January 2007 and January 2010. Patients were assessed with the Harris Hip Score (HHS) and Postel-Merle d’Aubigné (MDA) score and Devane Score. The end point of the study was reoperation for any cause related to the prosthesis. At a mean follow up of 38.6 months there were a total of 142 patients with hip resurfacing (group 1) [100 Durom® (Zimmer Inc., Warsaw, IN, USA) and 42 Birmingham Hip Resurfacing® (Smith &amp; Nephew, Memphis, TN, USA)] and 278 patients with total hip arthroplasty (group 2). The results showed significantly greater gain of HHS, MDA and Devane score with hip resurfacing procedures. However, considering all the complications, the rate was significantly higher in group 16.4% <em>vs</em> 1.79% in group 2 (P&lt;0.0001). In group 1 we observed 6 complications only concerned males with Durom® implants. The follow up of this cohort is still on going and may deliver more information on the evolution of these results in time.


2020 ◽  
Author(s):  
Weiguang Yu ◽  
Mao Shuai ◽  
Jinluan Lin ◽  
Baomin Chen ◽  
Mingdong Zhao ◽  
...  

Abstract Background The purpose of this retrospective study was to assess clinical outcomes following failed metal-on-metal hip resurfacing arthroplasty (MoM-HRA) revised using ceramic-on-ceramic total hip arthroplasty (CoC-THA) via the direct anterior approach (DAA).Methods Data involving 112 patients (112 hips) with failed primary MoM-HRA that was revised using CoC-THA via the DAA during 2006 - 2018 were retrospectively analysed. The mean age was 54.6 years (45–63 years). Frequent surgical indications for conversion were aseptic loosening and femoral neck fracture. The primary endpoint was the Postel-Merle d’Aubigne functional score (PMA). Secondary endpoints were the major orthopaedic complication rate and serum metal ion levels (chromium and cobalt).Results The mean follow-up time was 10 years (range, 4 - 13 years). The mean PMA improved from 9 (4-14) to 16 (13-18) (p = 0.001). Six patients had undergone a re-revision intervention. Fourteen incidents of aseptic loosening and four periprosthetic fractures were observed. A consistent decline in mean serum metal ion levels was detected [chromium decreased from 36.6 μg/L (12.5-76.5 μg/L) prior to conversion to 2.6 μg/L (0.1-13.5 μg/L) at final follow-up (p = 0.001), cobalt decreased from 37.5 μg/L (6.7-93.2 μg/L) to 2.2 μg/L (1.2-18.4 μg/L) (p =0.003)].Conclusion Failed primary MoM-HRA converted to CoC-THA using the DAA yielded acceptable clinical outcomes.


2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Nam Hoon Moon ◽  
Min Uk Do ◽  
Jung Shin Kim ◽  
Jae Seung Seo ◽  
Won Chul Shin

AbstractThis study aimed to evaluate the early results of primary total hip arthroplasty (THA) using dual mobility (DM) cups in patients at a risk of dislocation and compare them with that of fixed bearing (FB) THA. This retrospective study included patients who had undergone primary THA between January 2016 and December 2018 and were at a risk of dislocation. A propensity score-matched analysis was conducted for 63 THA procedures with vitamin-E infused highly cross-linked polyethylene (VEPE) DM bearing and 63 THA procedures performed with FB from the same manufacturer for a mean follow-up period of 3.1 and 3.5 years, respectively. The radiologic outcomes at the last follow-up and incidence of postoperative complications were evaluated and compared statistically between the two groups. The modified Harris hip score (mHHS) was used to assess patient-reported outcomes. Postoperative dislocation occurred in 4 cases (6.3%) in the FB group, but did not occur in the DM group (p = 0.042). There was no difference in the radiologic outcomes and postoperative complications between the two groups. The mHHS at the last follow-up showed satisfactory outcomes in both the groups (DM group, 90.5; FB group, 88.1), without a statistical difference between the groups. The early results of THA using VEPE DM bearing showed better outcomes than that of THA with FB for patients at a risk of dislocation. A longer follow-up period is recommended to assess the stability and overall outcomes.


Author(s):  
Marcelo Siqueira ◽  

AbstractThis study compared patient-reported outcome measures (PROMs), readmissions, and reoperations between hip resurfacing (HR) and total hip arthroplasty (THA) in a matched prospective cohort. Between 2015 and 2017, 4,268 patients underwent HR or THA at a single institution. A prospective cohort of 2,147 patients were enrolled (707 HRs, 1,440 THAs). PROMs were collected at baseline and 1-year follow-up. Exclusion criteria: females (n = 2,008), inability/refusal to complete PROMs (n = 54), and diagnosis other than osteoarthritis (n = 59). Each HR patient was age-matched to a THA patient. Multivariate regression models were constructed to control for race, body mass index, education, smoking status, Charlson Comorbidity Index, mental health, and functional scores. A significance threshold was set at p = 0.017. A total of 707 HRs and 707 THAs were analyzed and 579 HRs (81.9%) and 490 THAs (69.3%) were followed up at 1 year. There was no statistically significant difference for Hip Injury and Osteoarthritis Outcomes Score (HOOS) Pain subscale (p = 0.129) and HOOS-Physical Function Shortform (HOOS-PS) (p = 0.03). HR had significantly higher median University of California in Los Angeles (UCLA) activity scores (p = 0.004). Ninety-day readmissions for HR and THAs were 1.8 and 3.5%, respectively (p = 0.06), and reoperations at 1 year were 1.2 and 2.3%, respectively (p = 0.24). For male patients, differences in medians for UCLA activity scores were 0.383 points, which were statistically significant but may not be clinically relevant. No differences exist in 90-day readmissions, reoperations, and HOOSpain and HOOS-PS scores. Because patients undergoing HR are advised to return to full activity at 1-year postoperative, follow-up is required. Metal ion levels were not obtained postoperatively for either group.


2021 ◽  
Author(s):  
Nam Hoon Moon ◽  
Min Uk Do ◽  
Jung Shin Kim ◽  
Jae Seung Seo ◽  
Won Chul Shin

Abstract Introduction This study aimed to evaluate the early results of primary total hip arthroplasty (THA) using dual mobility (DM) cups in patients at a risk of dislocation and compare them with that of fixed bearing (FB) THA. Materials and methods This retrospective study included patients who had undergone primary THA between January 2016 and December 2018 and were at a risk of dislocation. A propensity score-matched analysis was conducted for 63 THA procedures with vitamin-E infused highly cross-linked polyethylene (VEPE) DM bearing and 63 THA procedures performed with FB from the same manufacturer for a mean follow-up period of 3.1 and 3.5 years, respectively. The radiologic outcomes at the last follow-up and incidence of postoperative complications were evaluated and compared statistically between the two groups. The modified Harris hip score (mHHS) was used to assess patient-reported outcomes. Results Postoperative dislocation occurred in 4 cases (6.3%) in the FB group, but did not occur in the DM group (p = 0.042). There was no difference in the radiologic outcomes and postoperative complications between the two groups. The mHHS at the last follow-up showed satisfactory outcomes in both the groups (DM group, 90.5; FB group, 88.1), without a statistical difference between the groups. Conclusion The early results of THA using VEPE DM bearing showed better outcomes than that of THA with FB for patients at a risk of dislocation. A longer follow-up period is recommended to assess the stability and overall outcomes.


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