Do Young, Active Patients Perceive Advantages After Surface Replacement Compared to Cementless Total Hip Arthroplasty?
- 741 Downloads
Potential advantages suggested but not confirmed for surface replacement arthroplasty (SRA) over THA include lower frequency of limp, less thigh pain, less limb length discrepancy, and higher activity.
We therefore determined whether patients having SRA had a limp, thigh pain, or limb length discrepancy less frequently or had activity levels higher than patients having THA.
In a multicenter study, we surveyed 806 patients aged 18 to 60 years with a premorbid UCLA activity score of 6 or more who underwent hip arthroplasty for noninflammatory arthritis at one of five orthopaedic centers. Patients had either a cementless THA with an advanced bearing surface (n = 682) or an SRA (n = 124). The patients were demographically comparable. Specific telephone survey instruments were designed to assess limp, thigh pain, perception of limb length, and activity levels. Minimum followup was 1 year (mean, 2.3 years; range, 1.1–3.9 years).
When controlled for age, sex, and premorbid activity level, patients with SRA had a higher incidence of complete absence of any limp, lower incidence of thigh pain, lower incidence of perception of limb length discrepancy, greater ability to walk continuously for more than 60 minutes, higher percentage of patients who ran after surgery, greater distance run, and higher percentage of patients who returned to their most favored recreational activity.
When interviewed by an independent third party, patients with SRA reported higher levels of function with fewer symptoms and less perception of limb length discrepancy compared to a similar cohort of young, active patients with THA.
Level of Evidence
Level III, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
We thank the UWSC, especially John Stevenson BA and Bob Cradock MS for all their help completing this project and Angel Poucher AAS for her assistance with preparing the manuscript.
- 1.American Association for Public Opinion Research. Standard definitions: final dispositions of case codes and outcome rates for surveys. 7th ed. 2011. Available at: http://www.aapor.org/AM/Template.cfm?Section=Standard_Definitions2&Template=/CM/ContentDisplay.cfm&ContentID=3156. Accessed January 3, 2013.
- 3.Australian Orthopaedic Association National Joint Replacement Registry. Annual Report. 2012. Available at: https://aoanjrr.dmac.adelaide.edu.au/documents/10180/60142/Annual%20Report%202012?version=1.2&t=1355186837517. Accessed January 6, 2013.
- 7.Canadian Hip Resurfacing Study Group. A survey on the prevalence of pseudotumors with metal-on-metal hip resurfacing in Canadian academic centers. J Bone Joint Surg Am. 2011;93(suppl 2):118–121.Google Scholar
- 8.Centers for Disease Control and Prevention. Prevalence of cholesterol screening and high blood cholesterol among adults - United States, 2005, 2007, and 2009. MMWR Morb Mortal Wkly Rep. 2012;61:697–702.Google Scholar
- 10.DeHaan R, Pattyn C, Gill HS, Murray DW, Campbell PA, DeSmet K. Correlation between inclination of the acetabular component and metal ion levels in metal-on-metal hip resurfacing replacement. J Bone Joint Surg Br. 2008;90:1291–1297.Google Scholar
- 11.Della Valle CJ, Nunley RM, Barrack RL. When is the right time to resurface? Orthopedics. 2008;31(12 suppl 2).Google Scholar
- 17.Gubrium JF, Holstein JA, eds. Handbook of Inverview Research: Context and Method. Thousand Oaks, CA: Sage Publications, Inc; 2002.Google Scholar
- 25.Likert R. A technique for the measurement of attitudes. Arch Psychol. 1932;140:1–55.Google Scholar
- 28.Marsden PV, Wright JD, eds. Handbook of Survey Research. 2nd ed. Bingley, UK: Emerald Group Publishing Ltd; 2010.Google Scholar
- 33.Nunley RM, Ruh EL, Zhang Q, Della Valle CJ, Engh CA Jr, Berend ME, Parvizi J, Clohisy JC, Barrack RL. Do patients return to work after hip arthroplasty surgery? J Arthroplasty. 2011;26(6 suppl):92–98.e1-3.Google Scholar