Polyethylene hip resurfacing in patients with lower leg amputations

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Rehabilitation Medicine

Background:

• Lower leg amputations increase the risk of early-onset hip osteoarthritis.
• Hip resurfacing arthroplasty (HRA) is a bone-preserving alternative to total hip arthroplasty for amputees.
• Altered gait mechanics in amputees may benefit from HRA's stability and functional advantages.

Purpose of the Study:

• To evaluate the success of HRA as an alternative to total hip replacement in lower extremity amputees.
• To assess functional outcomes and implant survivorship in amputee patients undergoing HRA.

Main Methods:

• Observational study of 39 amputee patients (45 hips) who underwent HRA.
• Patient-reported outcomes measured using HOOS, HHS, MCID, and PASS.
• Long-term follow-up included implant survivorship, complications, and radiographic assessment.

Main Results:

• Mean follow-up of 13 years showed high patient satisfaction (85% PASS) and functional scores (mean HOOS 90, mean HHS 92).
• 92% of patients achieved minimal clinically important difference.
• Leg length discrepancies were common (85%) but did not impact outcomes or survivorship.

Conclusions:

• HRA is a successful and viable surgical option for patients with lower limb amputations requiring hip arthroplasty.
• Leg length differences are frequent in this population but do not negatively affect implant survivorship or patient-reported outcomes.
• HRA provides significant functional benefits and high implant survival rates in amputee patients.