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Hip resurfacing arthroplasty: time to consider it again? No
James D Slover1, Harry E Rubash
1Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.
Instructional Course Lectures
|April 11, 2008
Summary
Total hip arthroplasty (THA) remains superior to hip resurfacing arthroplasty. Hip resurfacing poses unique risks and has not demonstrated improved functional outcomes, making it unwarranted for reconsideration.
Area of Science:
- Orthopaedic surgery
- Biomedical engineering
- Implantable medical devices
Background:
- Total hip arthroplasty (THA) is a highly successful and durable orthopaedic procedure.
- Hip resurfacing arthroplasty (HRA) is a newer alternative procedure for hip replacement.
- Any new procedure must demonstrate clear superiority over the established THA standard.
Purpose of the Study:
- To evaluate the current standing of hip resurfacing arthroplasty (HRA) as a viable alternative to total hip arthroplasty (THA).
- To compare the risks, outcomes, and biomechanical restoration of HRA versus THA.
- To assess the evidence supporting claims of superior functional outcomes for HRA.
Main Methods:
- Comparative analysis of existing literature on THA and HRA.
- Review of surgical risks, implant survival rates, and biomechanical restoration associated with both procedures.
- Examination of functional outcome studies comparing HRA and THA.
Main Results:
- Total hip arthroplasty (THA) demonstrates superior short-term implant survival compared to hip resurfacing arthroplasty (HRA).
- Hip resurfacing arthroplasty (HRA) carries unique risks including malpositioning, femoral neck fracture, and biomechanical challenges.
- Limited literature supports superior functional outcomes for HRA over THA.
Conclusions:
- Hip resurfacing arthroplasty (HRA) does not currently meet the standard of care set by total hip arthroplasty (THA).
- Concerns regarding metal ion effects and revision challenges persist for HRA.
- Reconsideration of HRA is not warranted without robust comparative studies demonstrating clear patient benefits over THA.
