Adoption of Hip Resurfacing Arthroplasty at Hospital for Special Surgery: a Cohort Study
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Hip resurfacing arthroplasty (HRA) is an alternative to traditional total hip replacement (THR) that allows for the preservation of femoral bone. It is a more technically difficult procedure that has led some researchers to report an unsatisfactory learning curve (Berend et al., J Bone Joint Surg Am Suppl 2:89–92, 2011; Mont et al., Clin Orthop Relat Res 465:63–70, 2007).
The purpose of this study was to investigate the adoption of HRA at our institution, examining the clinical results, revision rate, and modes of failure. Additionally, a comparison of three different implant systems was performed.
A retrospective review of a consecutive series of HRA performed at our institution between the years 2004 and 2009 was carried out. A total of 820 HRA with a minimum of 2 years of follow-up were included in the study. The majority of included patients were males (70%), with osteoarthritis (92%). The average age was 49.8 years, and the mean BMI was 27.5 kg/m2.
The average Harris hip score improved from 61 to 96.5 postoperatively. Thirteen revisions (1.6%) were performed for femoral neck fracture, femoral head osteonecrosis, acetabular loosening, metal reactivity/metallosis, and metal allergy. The overall Kaplan–Meier survival curve with revision surgery as an endpoint showed 98.5% survival at 5 years. There were no observable differences in clinical scores or revision rates between the different implant systems.
HRA can be successfully adopted with a low complication rate, given careful patient selection, specialized surgical training, and use of good implant design.
- Amstutz, HC, Duff, MJ (2008) Eleven years of experience with metal-on-metal hybrid hip resurfacing: a review of 1000 conserve plus. J Arthroplasty. 23: pp. 36-43 CrossRef
- Amstutz, HC, Duff, MJ, Campbell, PA, Wisk, LE, Takamura, KM (2011) Complications after metal-on-metal hip resurfacing arthroplasty. Orthop Clin North Am 42: pp. 207-230 CrossRef
- Amstutz, HC, Takamura, KM, Duff, MJ (2011) The effect of patient selection and surgical technique on the results of Conserve(R) Plus hip resurfacing—3.5- to 14-year follow-up. Orthop Clin North Am 42: pp. 133-142 CrossRef
- Beaule, PE, Duff, M, Campbell, P, Dorey, FJ, Park, SH, Amstutz, HC (2004) Metal-on-metal surface arthroplasty with a cemented femoral component: a 7-10 year follow-up study. J Arthroplasty. 19: pp. 17-22
- Berend, KR, Lombardi, AV, Adams, JB, Sneller, MA (2011) Unsatisfactory surgical learning curve with hip resurfacing. J Bone Joint Surg Am. 93: pp. 89-92 CrossRef
- Daniel, J, Pynsent, PB, McMinn, DJ (2004) Metal-on-metal resurfacing of the hip in patients under the age of 55 years with osteoarthritis. J Bone Joint Surg Br. 86: pp. 177-184 CrossRef
- Haan, R, Pattyn, C, Gill, HS, Murray, DW, Campbell, PA, Smet, K (2008) Correlation between inclination of the acetabular component and metal ion levels in metal-on-metal hip resurfacing replacement. J Bone Joint Surg Br. 90: pp. 1291-1297 CrossRef
- Glyn-Jones, S, Pandit, H, Kwon, YM, Doll, H, Gill, HS, Murray, DW (2009) Risk factors for inflammatory pseudotumour formation following hip resurfacing. J Bone Joint Surg Br. 91: pp. 1566-1574 CrossRef
- Grammatopolous, G, Pandit, H, Kwon, YM (2009) Hip resurfacings revised for inflammatory pseudotumour have a poor outcome. J Bone Joint Surg Br. 91: pp. 1019-1024 CrossRef
- Jolley, MN, Salvati, EA, Brown, GC (1982) Early results and complications of surface replacement of the hip. J Bone Joint Surg Am. 64: pp. 366-377
- Khan, M, Kuiper, JH, Edwards, D, Robinson, E, Richardson, JB (2009) Birmingham hip arthroplasty: five to eight years of prospective multicenter results. J Arthroplasty. 24: pp. 1044-1050 CrossRef
- Langton, DJ, Joyce, TJ, Jameson, SS (2011) Adverse reaction to metal debris following hip resurfacing: the influence of component type, orientation and volumetric wear. J Bone Joint Surg Br. 93: pp. 164-171 CrossRef
- Mont, MA, Seyler, TM, Ulrich, SD (2007) Effect of changing indications and techniques on total hip resurfacing. Clin Orthop Relat Res. 465: pp. 63-70
- Nunley, RM, Zhu, J, Brooks, PJ (2010) The learning curve for adopting hip resurfacing among hip specialists. Clin Orthop Relat Res. 468: pp. 382-391 CrossRef
- Pandit, H, Glyn-Jones, S, McLardy-Smith, P (2008) Pseudotumours associated with metal-on-metal hip resurfacings. J Bone Joint Surg Br. 90: pp. 847-851 CrossRef
- Shimmin, AJ, Bare, J, Back, DL (2005) Complications associated with hip resurfacing arthroplasty. Orthop Clin North Am 36: pp. 187-193 CrossRef
- Su, EP, Sheehan, M, Su, SL (2010) Comparison of bone removed during total hip arthroplasty with a resurfacing or conventional femoral component: a cadaveric study. J Arthroplasty. 25: pp. 325-329 CrossRef
- Vendittoli, PA, Ganapathi, M, Roy, AG, Lusignan, D, Lavigne, M (2010) A comparison of clinical results of hip resurfacing arthroplasty and 28 mm metal on metal total hip arthroplasty: a randomised trial with 3-6 years follow-up. Hip Int. 20: pp. 1-13
- Adoption of Hip Resurfacing Arthroplasty at Hospital for Special Surgery: a Cohort Study
HSS Journal ®
Volume 8, Issue 3 , pp 283-286
- Cover Date
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- hip resurfacing arthroplasty
- learning curve
- Industry Sectors
- Author Affiliations
- 1. Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA
- 2. Clinical Orthopaedic Surgery, Weill Cornell Medical College, New York, NY, 10065, USA
- 3. Orthopedic Surgery, St. Joseph’s Regional Medical Center, Patterson, NJ, USA