Quality of life in different age groups after metal-on-metal hip resurfacing arthroplasty

Hip resurfacing arthroplasty is known to improve quality of life (QoL) and allow increased activity levels in young patients. It is, however, traditionally offered to the younger age group of patients, largely those aged under 60 years. We studied 42 consecutive patients (42 hips) aged 60 years or over (mean age 64) and 41 consecutive patients (42 hips) under this age (mean age 49), all of whom had undergone a metal-on-metal hip resurfacing arthroplasty. A modified Harris hip score was translated to QoL scores using the Rosser Index Matrix immediately pre-operatively, and at six weeks, six months, one year and four years after surgery. We found a significant improvement in QoL for both groups (p <0.0001) but no difference between the two groups. The maximum improvement was reached one year after surgery. Implant survival at four years was also similar (97.6% for group I and 100% for group II). We thus conclude that in carefully selected active patients aged 60 years and over, hip resurfacing arthroplasty provides significant and equal QoL improvement as it does for those under this age with similar implant survival. For this reason, age alone should not influence a surgeon's decision to proceed with a hip resurfacing arthroplasty.