THE WRIGHTINGTON EXPERIENCE WITH METAL ON METAL RESURFACING HIP ARTHROPLASTY

Abstract

Aim of the study: To evaluate the results of metal-on-metal resurfacing hip arthropalsty in young patients

Materials and Methods: Between February 2000 and December 2004, this operation was performed in 181 patients (205 hips) using the posterior approach. The main indications were osteoarthritis, osteonecrosis, hip dysplasia, post-traumatic arthritis, perthe’s disease and slipped capital femoral epiphysis. There were 142 males and 39 females aged 26 to 68 years (average 47.4 years). 136 patients had a minimum 3 year follow-up (range 1–5 years). Clinical and radiological evaluation was performed at 3 months, 1 year, 2 years and 5 years from time of surgery. All patients were scored using the Charnley’s modification of Merle d’Aubigne score preoperatively and at last follow-up. Radiological evaluation included grading acetabular and femoral zones for loosening, determining stem-shaft angle, hip ratio. The endpoint for outcome evaluation was revision which was two in this series. Survivourship analysis was performed by Kaplan-Meier analysis. The results in our patients were encouraging with most returning to sporting activities at an average of 12 months. 1 patient with bilateral hip resurfacing had evidence of osteolysis after surgery and had occasional hip pain until last follow-up. Complications like neck fracture, heterotrophic ossification were not seen in our series.

Conclusion: Early results of metal-on-metal resufacing arthroplasty in our series are encouraging. Continued follow-up and evaluation remains important to determine the long term results of this operation.