Early Return to Function After Hip Resurfacing: Is It Better Than Contemporary Total Hip Arthroplasty?

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Abstract

Our hypothesis was that return of function for young patients undergoing resurfacing total hip arthroplasty (THA) with metal-on-metal bearings or contemporary THA with ceramic bearings would be comparable. Results from 337 unilateral hip resurfacing patients were compared with results from 266 unilateral ceramic-on-ceramic THA patients. Early differences in Harris Hip Scores were observed, but all differences faded by 24 months. Hip resurfacing seems to be a viable alternative to THA for well-selected patients. However, the public perception of improved functional capabilities was not demonstrated in this patient population. Resurfacing patients may be more impaired (slightly higher pain scores/lower function scores) than their THA counterparts in the early postoperative period, but these differences disappear by 24 months when both groups report Harris Hip Scores in the excellent range.

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Materials and Methods

Two comparable groups of young patients studied under investigational device exemption (IDE) conditions were available to evaluate the question of functional equivalency. The Harris Hip Score (HHS) and its subcomponents served as a surrogate measure of functional improvement for both groups.

A multicenter study governed by an IDE in the United States was conducted. The device under study was a metal-on-metal (MOM) total hip resurfacing product (Cormet 2000, Corin, UK) composed of 2 components—a

Results

The Cormet and control groups were well matched demographically with the exception of age. Sex, mean weight, diagnosis, and preoperative HHS mean total score were not statistically different (Table 1). Although the mean age of the groups (Cormet, 50.1 years; ABC, 53.3 years) was statistically different (P < .01), this was not felt to be clinically significant.

Discussion

Success rates currently reported in the literature suggest that resurfacing arthroplasty is a reasonable alternative to THA for appropriately selected patients. The Australian registry data [3] show that, overall, patients will have a 2.2% early revision rate for resurfacing compared to 1.9% for conventional THA. Others have reported overall survival rates of 94.4% to 97.1% for MOM hip resurfacing devices with at least 2 years of follow-up 4, 5. Long-term follow-up is clearly needed.

There is

Acknowledgments

The authors would like to thank the Cormet 2000 Hip Resurfacing IDE study investigators and supporting institutions, Corin USA, and Stryker Orthopaedics for their involvement and support of this project. This research was completed as part of the Cormet Hip Resurfacing PMA, Corin USA. The Cormet Hip Resurfacing IDE Study Group included Dr Gordon Allan, Dr William Bose, Dr David Feldman, Dr Thomas Gross, Dr Hany Helmy, Dr Allan Inglis, Dr Michael Jacobs, Dr William Kennedy, Dr Ralph Liebelt, Dr

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Benefits or funds were received in partial or total support of the research material described in this article. These benefits or support were received from the following sources: Research funds have been received from Stryker Orthopaedics/Corin USA in support of the material described in this article. In addition, BN Stulberg is a consultant for Stryker Orthopaedics; SM Fitts is an employee of Stryker Orthopaedics; and AR Bowen is an employee of Corin USA.

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