Abstract
Introduction: Hip resurfacing is a bone conserving option that offers a better revision prospect for young and active patients. Encouraging results from several centres prove that they function well in the early years. Their long-term survival will be known from continued monitoring of early resurfacings.
Methods: This is a retrospective study of two cohorts of young (< 55 years) patients of osteoarthritis treated with hybrid-fixed metal-metal resurfacings. The cohorts are a) consecutive patients treated by the senior author in 1994 and 95 with a hydroxyapatite-coated smooth uncemented cup and a cemented femoral component and b) consecutive patients treated with hydroxyapatite-coated porous uncemented cup and a cemented femoral component since 1997 with a minimum follow-up of 5 years. 420 resurfacings (360 patients, 287 males and 73 females) were reviewed with Oxford hip scores and activity level monitoring (UCLA scale). Mean age at operation was 48.3 years.
Results: Ten patients (11 hips) died from unrelated causes. Out of the remaining 409 hips (350 patients) at a follow-up of 5 to 11.5 years (mean 7.1 years), there was one failure (cumulative failure rate 0.25% at 11 years) from avascular necrosis of the femoral head. The mean Oxford score of the 350 patients is 13.4. 87% had a UCLA score of 7 and above. 55% participated in impact sports or were involved in heavy occupational work.
Discussion: In the present study, with no loss to follow-up, excellent hip survival (99.75%) and activity level were seen. Young patients regard return to activities as one of their highest priorities. None of these patients were advised to change their activities at work or leisure.
The extremely low failure rate in the medium term proves the suitability of resurfacing in young active patients. However, caution needs to be exercised until long term results are available.
Correspondence should be addressed to The Secretary, BHS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
