Abstract
Introduction Resurfacing hip arthroplasty is becoming an increasingly popular option in the management of hip arthritis in younger individuals. Large series from units pioneering the technique have yielded encouraging results, but smaller units have reported alarming complication rates in recent years. We report a single-surgeon series performed from within the ambit of a multicentre trial.
Method Data on 49 cases in 46 patients (28 males, 18 females, age 34–68, mean 50.6) were collected. Harris Hip scores were obtained preoperatively and at follow-up (6, 12, 24, 36 and 48 months, mean 16.2). Radiological assessment included evaluation of component position and possible migration. Technical difficulties with implant insertion were recorded.
Results Postoperative hip scores improved dramatically in 47 cases. 3 patients have thigh pain. In one case rotational displacement of the cup occurred over 3 months. This is asymptomatic. In 2 cases there was minor femoral neck notching during surgery, without complications. One femoral component was inserted in slight varus. There was incomplete seating of the acetabulum in 4 cases, without complications. Lateral guide pin protrusion occurred into the tissues during surgery in 2 cases, and this pin is no longer used. Painless clicking, possibly due to impingement, has been noted in 4 cases. There was 1 death, due to total mesenteric infarction. There have been no femoral neck fractures and no revisions in these cases, all performed via the anterolateral approach.
Discussion Resurfacing arthroplasty is more technically demanding than total hip replacement. All cases in this series were entered in a multicentre analysis, the benefits have including regular contact with other surgeons. The procedure is conservative on the femoral side at least, and conversion to hip replacement in the event of future femoral component loosening or neck fracture should be easy, although the results of articulation between a new stemmed device and an old (worn) cup are not known. The results of this single-surgeon series from a DGH, performed within the ambit of a large multi-centre analysis, have been encouraging.
Editoral Secretary Mr Peter Howard. Correspondence should be addressed to BHS at the Royal College of Surgeons, 35 - 43 Lincoln’s Inn Fields, London WC2A 3PN.
