Abstract
Background
Operation of hip resurfacing prosthesis is a technically demanding procedure accompanied by a learning curve. To our knowledge no objective data on this learning curve are available in the literature.
Methods
For the first 40 resurfacing hip prostheses implanted by a single-surgeon radiographic ‘learning curve’ analysis was performed. Optimal implant positioning on preoperative digital templating was compared with the eventual implant position postoperatively, measured by six establishes radiographic parameters and compared for four chronological cohorts of patients.
Results
A learning curve was clearly present and an optimal result was established in the last cohort. Pitfalls were a relatively steep cup position initially and a stem position in the posterior 1/3 of the collum. Besides marginal medialization a fully anatomic reconstruction of the center of rotation was achieved.
Conclusion
In total hip resurfacing one should recognize the presence of a learning curve. This learning curve appears to be acceptable and a reproducible optimal implant positioning can be achieved quickly.
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References
Amstutz HC, Beaulé PE, Dorey FJ, Le Duff MJ, Campbell PA, Gruen TA (2006) Metal-on metal hybrid surface arthroplasty. Surgical technique. J Bone Joint Surg Am 88(Suppl 1 Pt 2):234–249
Amstutz HC, Ball ST, Le Duff MJ, Dorey FJ (2007) Resurfacing THA for patients younger than 50 years: results of 2- to 9-year follow-up. Clin Orthop Relat Res 460:159–164
Anglin C, Masri BA, Tonetti J, Hodgson AJ, Greidanus NV (2007) Hip resurfacing femoral neck fracture influenced by valgus placement. Clin Orthop Relat Res 465:71–79
Ball ST, Le Duff MJ, Amstutz HC (2007) Early results of conversion of a failed femoral component in hip resurfacing arthroplasty. J Bone Joint Surg Am 89(4):735–741
Barrett AR, Davies BL, Gomes MP, Harris SJ, Henckel J, Jakopec M, Rodriguez y Baena FM, Cobb JP (2006) Preoperative planning and intraoperative guidance for accurate computer-assisted minimally invasive hip resurfacing surgery. Proc Inst Mech Eng [H] 220(7):759–773
Beaulé PE, Le Duff MJ, Dorey FJ, Amstutz HC (2003) Fate of cementless acetabular components retained during revision total hip arthroplasty. J Bone Joint Surg Am 85:2288–2293
Beaulé PE, Dorey FJ, Le Duff MJ, Gruen T, Amstutz HC (2004) Risk factors affecting outcome of metal-on-metal surface arthroplasty of the hip. Clin Orthop Relat Res 418:87–93
Beaulé PE, Lee JL, Le Duff MJ, Amstutz HC, Ebramzadeh E (2004) Orientation of the femoral component in surface arthroplasty of the hip. A biomechanical and clinical analysis. J Bone Joint Surg Am 86:2015–2021
Cobb JP, Kannan V, Brust K, Thevendran G (2007) Navigation reduces the learning curve in resurfacing total hip arthroplasty. Clin Orthop Relat Res 463:90–97
Cuckler JM (2006) The optimal metal-metal arthroplasty is still a total hip arthroplasty: in the affirmative. J Arthroplasty 21(4 Suppl 1):74–76
Girard J, Lavigne M, Vendittoli PA, Roy AG (2006) Biomechanical reconstruction of the hip: a randomised study comparing total hip resurfacing and total hip arthroplasty. J Bone Joint Surg Br 88(6):721–726
Gofton W, Dubrowski A, Tabloie F, Backstein D (2007) The effect of computer navigation on trainee learning of surgical skills. J Bone Joint Surg Am 89:2819–2827
Grigoris P, Roberts P, Panousis K, Bosch H (2005) The evolution of hip resurfacing arthroplasty. Orthop Clin North Am 36(2):125–134
Kim WC, Grogan T, Amstutz HC, Dorey F (1987) Survivorship comparison of THARIES and conventional hip arthroplasty in patients younger than 40 years old. Clin Orthop Relat Res 214:269–277
Long JP, Bartel DL (2006) Surgical variables affect the mechanics of a hip resurfacing system. Clin Orthop Relat Res 453:115–122
Schmalzried TP (2006) The optimal metal-metal arthroplasty is still a total hip arthroplasty: in opposition. J Arthroplasty 21(4 Suppl 1):77–79
Silva M, Lee KH, Heisel C, Dela Rosa MA, Schmalzried TP (2004) The biomechanical results of total hip resurfacing arthroplasty. J Bone Joint Surg Am 86-A(1):40–46
Vail TP, Mina CA, Yergler JD, Pietrobon R (2006) Metal-on-metal hip resurfacing compares favorably with THA at 2 years followup. Clin Orthop Relat Res 453:123–131
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Witjes, S., Smolders, J.M.H., Beaulé, P.E. et al. Learning from the learning curve in total hip resurfacing: a radiographic analysis. Arch Orthop Trauma Surg 129, 1293–1299 (2009). https://doi.org/10.1007/s00402-009-0875-z
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DOI: https://doi.org/10.1007/s00402-009-0875-z