Ten year follow-up of hip resurfacing in patients under thirty years old

As an alternative to total hip arthroplasty (THA), hip resurfacing arthroplasty (HRA) has numerous advantages including low risk of dislocation, preservation of femoral bone stock, and no restrictions on high-impact sports. This study was designed to evaluate the results of HRA performed in patients under 30 years old with a long-term follow-up.

All HRA performed in patients younger than 30 years at the time of surgery were reviewed with a minimum follow up of two years. The analysis was based on clinical data, patient-recorded outcomes measures, biological and radiological evaluation.

One-hundred three HRA procedures in 93 patients (77 males and 16 females) were included. Mean age at surgery was 27.7 years (18 to 29.9). The two most frequent indications were osteoarthritis in 52% (54 HRA) and developmental dysplasia of the hip in 19% (20 HRA). There were two revisions: one for femoral aseptic loosening and one for infection. No dislocation or adverse wear-related failures were found. At a mean follow-up of 10.4 years (2-17.4), the mean UCLA activity and Oxford Hip score improved from 5.4 (1 to 7) and 39.9 (25-55) preoperatively to 7.9 (3 to 10) and 15.8 (12-34) postoperatively (p < 0.001), respectively. Kaplan-Meier survival analysis, with revision for any reason as the endpoint, showed a 10.8-year survival rate of 98%.

This cohort of HRA in patients under 30 years old is the longest follow-up ever reported. Despite HRA being done in a challenging cohort of patients, it shows excellent survivorship with a low complication rate.