Hip Resurfacing Arthroplasty in Men: A Minimum 15-Year Follow-Up Study

Hip resurfacing arthroplasty (HRA) has emerged as an alternative to total hip arthroplasty for managing osteoarthritis, particularly in younger, active men. However, long-term data on HRA outcomes in the United States remains limited.

We retrospectively examined 472 consecutive HRA cases in 407 men performed between January 2006 and December 2008 with minimum 15-year follow-up outcomes. Patient-reported outcome measures, including the modified Harris Hip Score, Hip Disability and Osteoarthritis Outcome Score for Joint Replacement, Visual Analog Scale for pain, and University of California-Los Angeles Activity Scale, were collected. Serum metal ion levels, survivorship, and radiographic outcomes were also assessed. Kaplan-Meier survival analysis was performed to evaluate implant survivorship. The mean follow-up was 16.0 years (range, 15.0 to 18.4).

The overall survivorship at 15 years was 95.1%. Implants with femoral head sizes ≥ 48 mm demonstrated 95.8% survivorship, while those < 48 mm showed 91.3% survivorship. For unrevised hips, mean final follow-up scores were Hip Disability and Osteoarthritis Outcome Score for Joint Replacement 97.8 ± 5.6, modified Harris Hip Score 97.3 ± 6.4, Visual Analog Scale 0.4 ± 1.1, and University of California-Los Angeles Activity 8.0 ± 1.9. The median serum metal ion levels at the final follow-up were 2.3 μg/L for chromium and 1.7 μg/L for cobalt. There were 26 revisions that occurred, with aseptic loosening being the most common cause (n = 11).

This study demonstrates that HRA is a viable long-term solution for appropriately selected men with high survivorship and positive functional outcomes at a minimum 15-year follow-up.