HIP RESURFACINGS IN PATIENTS AGED 65 YEARS AND OVER? – A SINGLE SURGEON SERIES OF 111 HIP RESURFACINGS WITH A UNIQUE GROUP OF SELECTION CRITERIA.

Abstract

This bone preserving procedure is less well described in the much older population over 65 years of age. Despite good bone quality, independence and active lifestyle, older age seems to be a deterrent for hip resurfacings among most orthopaedic surgeons.

Analysis of 111 Birmingham hip resurfacings in 105 consecutive patients from 1999 to 2007 performed by a single surgeon was carried out to determine radiological and clinical outcome. The unique selection criteria looked at joint disease, activity levels, general health, imaging (Xray/CT/MRI) and Bone density studies.

28 females and 77 males with mean age of 69.5 years (65–87 years, SD +/− 4), body mass index of 27.2 (19–40.4, SD +/− 3.8) underwent resurfacings. 8 patients had bilateral, consecutive 2 stage procedures. Mean Follow up was 3.8 years ranging from 3 months to 7 years. 62 resurfacings were performed in the age group 65–69 yrs, 32 resurfacings in the 70–74 age group, 12 resurfacings in the 75–79 age group and 4 resurfacings in the 80–89 age group. 77 patients (71.3%) stayed one night or less in hospital. 4 patients (3 males and 1 female) had postoperative fracture neck of femora.

Radiographic review at the most recent follow up revealed non of the patients (101) who had the original hip resurfacing components had any evidence of gross loosening, migration or subsidence requiring revision of either the cup or the femoral components. No patients complained of localised hip pain and at the most recent follow up they had very good to excellent function with no report of dislocations.

Hip resurfacing is a challenge in patients who are over the age of 65 years. Using our selection criteria, it may be offered to active, independent patients with good bone quality as this age group in the population becomes larger with time.