2011 Volume No 21 – pages 243-258
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Title: Hip resurfacing arthroplasty: current status and future perspectives |
Author: K Corten, R Ganz, J-P Simon, M Leunig |
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Address: Schulthess Clinic, Lengghalde 2, CH-8008 Zürich, Switzerland |
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E-mail: michael.leunig at kws.ch |
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Key Words: Hip resurfacing, surface replacement arthroplasty, national joint replacement registry. |
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Publication date: March 15th 2011 |
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Abstract: Hip resurfacing arthroplasty (HRA) is a concept of hip replacement that allows treating young active patients with a femoral bone preserving procedure. The proposed advantages of resuming an active lifestyle with increased frequency and duration of sports activities have been shown to be realistic. The 30-year cost-effectiveness in young male patients has been shown to be higher in resurfacing compared to conventional total hip replacement (THA). However, prognosticators of an inferior outcome have also been identified. The most important patient related factors are secondary osteoarthritis as the indication for surgery such as post-childhood hip disorders or AVN, female gender, smaller component sizes and older age (>65 years for males and >55 years for females). In addition, surgical technique (approach and cementing technique) and component design are also important determinant factors for the risk of failure. Moreover, concerns have surfaced with respect to high metal ion concentrations and metal ion hypersensitivities. In addition, the presumed ease of revising HRA has not reflected in improved or equal survivorship in comparison to a primary THA. This highlights the importance of identifying patient-, surgery-, and implant-related prognosticators for success or failure of HRA. Rather than vilifying the concept of hip resurfacing, detailed in depth analysis should be used to specify indications and improve implant design and surgical techniques. |
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Article download: Pages
243-258 (PDF file) |
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