RETURN TO SPORTS AFTER SURFACE REPLACEMENT ARTHROPLASTY AND TOTAL HIP ARTHROPLASTY: A RANDOMIZED CLINICAL TRIAL

Abstract

PURPOSE: The purpose of this study was to compare the level of post operative sport activity in a randomized study of SRA and THA.

INTRODUCTION: Return to high activity level has been proposed has an advantage of hip resurfacing (SRA) compared to THA. However, patient selection for SRA favours higher demand individuals, thus leading to a biased comparison of both techniques.

MATERIALS AND METHODS: Patients were randomized to THA or SRA. At minimum one year follow-up, the patients were asked about the activities they have resumed, the level of satisfaction regarding return to sports and the factors limiting full return to intense activities. 80 THA and 85 SRA with a mean follow-up of 16 months were analyzed.

RESULTS: The postoperative UCLA activity score was significantly higher in the SRA group (6.3 versus 7.1, p< 0.05). 77% of the SRA patients returned to high or moderate activity level vs 39% in the THA group (p=0.007). In the THA group, the activity level was mostly restricted due to concern about instability. However, some THA patients were still able to perform high demand activities.

DISCUSSION AND CONCLUSION: This study suggests that SRA allows return to higher activity level when compared to THA. This may be due in part to the larger diameter head of SRA which improves stability and suction-fit (reducing micro separation of the bearing during activities). Enhanced proprioception due to the retained femoral neck may also be involved in the bias towards SRA. Further follow-up is will determine if higher activity level is detrimental to implant survivorship