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General Orthopaedics

MINIHIP ARTHROPLASTY VERSUS HIP RESURFACING FOR YOUNGER PATIENTS

The International Society for Technology in Arthroplasty (ISTA), 28th Annual Congress. PART 2.



Abstract

Introduction

Hip Resurfacing has been shown to be a valuable treatment for younger osteoarthritis patients related to functional outcomes. On the other hand, there is a higher risk for potential neck fractures and there is serious concern over metal-ion release and related health risks associated with the current metal-on-metal designs. Neck-preserving, short-stem implants may be a good alternative for younger patients. The current study investigated patient-reported outcomes from resurfacing and total hip arthroplasty (THA) with a neck preserving, short-stem implant (Corin MiniHip®).

Methods

Hip disability and osteoarthritis outcome scores (HOOS) from a young group of patients (n= 52, age 48.9±6.1 years) who underwent hip resurfacing surgery and a cohort of patients who underwent MiniHip® THA surgery (n=73, age 48.2±6.6) were compared. MANCOVA analysis was conducted including follow-up period as covariate. To compare complexity of the surgical intervention, the average durations for both types of surgery were compared using non-parametric testing (Mann-Whitney's U).

Results

As expected, both surgical interventions were associated with significant improvements in HOOS scores (p<0.0001, h2=.69); however, there were no group effects or interactions related to any of the HOOS subscales. Surgery duration was significantly longer for Resurfacing (104.4min±17.8) than for MiniHip® surgery (62.5min±14.8), U=85.0, p<0.0001, h2=.56.

Conclusions

The current results indicate that the neck-preserving, short-stem approach via MiniHip Arthroplasty is equal to Resurfacing in terms of younger patients’ outcomes, while requiring shorter surgery duration. Additionally, there are serious concerns regarding the metal-on-metal designs of Resurfacing implants, which provides more support for the value of the presented short-stem alternative. Future research will aim at a longer-term (>5 years) evaluation of outcomes.


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