Abstract
Introduction: The advent of metal on metal resurfacing in the United Kingdom has resulted in increasing interest in the procedure. The operation is more demanding than primary joint replacement and the complications involved are frequently peculiar to the technique. We present a single-surgeon series from a district hospital performed within the ambit of a larger multicentre study.
Method: Data on 83 cases in 80 patients (51 males, 29 females, age 34y–68y, mean age 50.6y) were collected. Patients were reviewed preoperatively and postoperatively at 6 months and annually (mean 21 months, range 1–60 months). At review Harris Hip scores were recorded with a radiological assessment to assess implant orientation. Technical difficulties with implant insertion were recorded. All cases were approached via an anterolateral exposure.
Results: Postoperative scores improved dramatically in nearly all cases. There was persistent pain in two cases, one of spinal origin, the other unexplained. 2 loose femoral components were revised at 2 and 3 years respectively years leaving the intact cup. 1 cup rotated slightly over 3 months and stopped, 4 cups were incompletely seated and 1 femoral component was inserted in slight varus. All remain asymptomatic to date. There was one unrelated death (mesenteric infarction) and no femoral neck fractures.
Discussion: Resurfacing arthroplasty is technically more demanding than total hip replacement and the exchange of experiences via a multicentre user group is important. The conservative nature of the device means that revision for fractured neck of femur (commonest cause of failure) to a stemmed implant retaining the cup is relatively easy. The results of this series are encouraging.
Correspondence should be addressed to The Secretary, BHS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
