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Hip resurfacing: indications, results, and conclusions.
Caroline Hing1, Diane Back, Andrew Shimmin
1Melbourne Orthopaedic Group, Melbourne, Australia.
Instructional Course Lectures
|May 3, 2007
Summary
Metal-on-metal hip resurfacing offers advantages for young patients with osteoarthritis but raises concerns about metal ion effects and long-term implant survival. Current revision rates are low, with femoral fracture as the main cause.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
Background:
- Hip resurfacing with metal-on-metal (MOM) bearings is increasingly used for young, active osteoarthritis patients.
- Theoretical benefits include bone preservation and lower dislocation risk compared to conventional hip arthroplasty.
Purpose of the Study:
- To evaluate the safety and efficacy of MOM hip resurfacing.
- To assess the long-term survival and revision rates of MOM hip resurfacing implants.
Main Methods:
- Review of hip resurfacing procedures using MOM bearings.
- Analysis of revision rates, focusing on reasons for revision.
- Calculation of cumulative survival rates at a specific follow-up period.
Main Results:
- Hip resurfacing accounts for 7.5% of hip replacements in Australia with a 2.2% revision rate.
- Femoral fracture is the most common reason for revision surgery.
- The cumulative survival rate at the authors' institution was 99.14% at 3-year follow-up.
Conclusions:
- MOM hip resurfacing presents potential benefits but carries concerns regarding metal ion toxicity and unknown long-term outcomes.
- While current revision rates are relatively low, femoral fracture remains a significant concern.
- Further long-term studies are needed to fully understand the implications of MOM hip resurfacing.