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TO REPLACE OR RESURFACE: OSTEOARTHRITIS OF THE HIP IN THE YOUNG ACTIVE PATIENT – A FIVE YEAR EVALUATION OF FUNCTIONAL OUTCOMES IN A MATCHED POPULATION



Abstract

Management of hip osteoarthritis in young active patients is made more challenging by the longevity required of the prostheses used and the level of activity they must endure. The aim of this study was to compare the functional outcomes and activity levels following hip resurfacing (HR) and uncemented total hip arthroplasty (UTHA) in young active patients matched for age, gender and activity levels.

255 consecutive hip arthroplasties performed in a teaching hospital were retrospectively reviewed from which were identified 58 UTHA patients and 58 HR patients, matched for age, gender and pre-operative activity level. Mean age of patients within UTHA was 58.5 years (34 – 65) and in HR was 57.9 years (43 – 68).

No patients within the study were lost to follow-up. Mean follow-up was five years.

Within each group there was a statistically significant improvement in the mean UCLA score following surgery (p=0.00). In the HR Group, mean UCLA score improved from 4.2 (1–8) to 6.7 (3–10) while in the UTHA group the mean UCLA score improved from 3.4 (1–7) to 5.8 (3–10). Mean OHS improved from 44.4 (31–57) to 16.6 (12–31) in the HR group and from 46.1 (16–60) to 18.8 (12–45) in the UTHA group, p = 0.00 each group.

This study found no statistically significant difference in the levels of function (p= 0.82) or activity pursued (p= 0.60) after surgery between UTHA and HR in a population of patients matched for age, gender and pre-operative activity levels.

This study has shown comparable outcomes with hip resurfacing and uncemented THA in terms of both functional outcomes and activity levels in a group of young active patients. The potential complications unique to hip resurfacing may be avoided by the use of uncemented THA. In addition, uncemented THA has a longer track record.


Correspondence should be sent to: Majid Chowdhry, Alexandra Hospital, Trauma and Orthopaedics, Woodrow Drive, Redditch, B98 7UB Worcestershire, United Kingdom, m.chowdhry@doctors.org.uk

The abstracts were prepared by Mr Matt Costa and Mr Ben Ollivere. Correspondence should be addressed to Mr Costa at Clinical Sciences Research Institute, University of Warwick, Clifford Bridge Road, Coventry CV2 2DX, UK.