Abstract
Hip resurfacing has grown rapidly since its introduction in the United States, as an alternative to total hip replacement in the younger, active patient. Some studies have suggested a steep learning curve and a higher complication rate when compared to THR. Existing studies have originated from the pioneering surgeons, using a specific type of resurfacing implant. The purpose of this study was to look at the experience of a single, non-inventor surgeon with the adoption of hip resurfacing, using 3 different implants.
M&M
All consecutive hip resurfacings performed by the senior surgeon between 2004 and 2008 were included, providing a minimum 2 year followup period. 3 different implant types were used; 2 of these were used as part of the clinical trials, and 1 was used after US FDA approval. A total of 560 hip resurfacings were eligible for the study based upon a minimum of 2 year followup.
Results
Nine revisions were performed in this cohort (1.6%). 2 were femoral conversions to endoprostheses for femoral neck fracture; 3 additional femoral conversions were done for osteonecrosis of the femoral head. 1 acetabular revision only was performed for malposition. 2 revisions to THR of both the acetabular and femoral components were done for acetabular loosening and excessive metal production (edge loading). There was 1 revision for metal hypersensitivity. Overall, the K-M survival curve is 98.1% at 4 years. There was no difference with regard to survival from additional surgery with regard to the different implant types.
Radiographic signs of failure were also documented. In this cohort, 3 femoral and 1 acetabular components were identified to be radiographically loose, giving a K-M survival from clinical and radiographic failure to be 96.8% at 4 years.
Discussion
Hip resurfacing can be adopted successfully with a low rate of reoperation, by the use of careful patient selection. A single surgeon's experience with 3 different types of implants demonstrated no difference in clinical results between the devices.
