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THE INDICATIONS FOR RESURFACING ARTHROPLASTY OF THE HIP



Abstract

In a study of 76 consecutive hip resurfacing arthroplasty procedures, the reasons for choosing this procedure rather than total hip arthroplasty (THA) were reviewed. Patient age, preoperative diagnosis, presence of bone deficiency and other technical factors were considered.

The mean age of patients, 79% of whom were men, was 44 years (20 to 76). The preoperative diagnosis in 59% of patients was osteoarthritis and in 37% avascular necrosis. The decision to resurface the hip rather than to perform THA was influenced primarily by the patient’s choice. In 43 cases (57%), the patient had prior knowledge of the procedure and specifically that it be considered. Other important considerations were the patient’s level of physical activity, the expectation of non-compliance with mobilisation and rehabilitation, the expectation of instability of the hip, the quality of bone and the surgeon’s experience with the surgical technique.

As experience of the procedure grew, the mean age of patients who underwent resurfacing arthroplasty increased. The early clinical results of resurfacing indicate that the range of motion is less than in hip replacement, that the resurfaced hip demands less care against dislocation or wear, and that the patient mobilises and rehabilitates more rapidly and reaches a higher level of physical ability than with THA. As mid-term and long-term results become available, the indications for and prevalence of hip resurfacing arthroplasty are likely to increase.

The abstracts were prepared by Professor M.B.E. Sweet. Correspondence should be addressed to him at PO Box 47363, Parklands, Johannesburg 2121, South Africa.