Outcomes after metal-on-metal hip resurfacing: could we achieve better function?
OBJECTIVE
To report functional outcomes after metal-on-metal (MOM) hip resurfacing.


METHODS
A cohort of 126 MOM hip resurfacing operations were reviewed 1 year after surgery.


METHODS
Hospital trust specializing in orthopedic surgery.


METHODS
Sixty-seven right and 59 left hips were reviewed in patients (N=120; 71 men, 49 women; mean age, 56+/-9y; range, 24-76y).


METHODS
Not applicable.


METHODS
Administered once at follow-up. Function was measured using the Oxford Hip Score (OHS), Hip disability and Osteoarthritis Outcome Score, and UCLA Activity Score. Complications, pain, range of motion, Trendelenburg test, strength, walking, single-leg stand, stair climbing, and 10-m walk time were assessed.


RESULTS
Overall examination was satisfactory with few complications. High functional levels were reported. The median OHS was 15 and median UCLA Activity Score 7 (active). For 25%, outcome was poor with persistent pain, reduced hip flexion (mean, 94.46 degrees +/-12.7 degrees ), decreased strength (P<.001), restricted walking, and functional limitations.


CONCLUSIONS
Information about outcomes is important for patients undergoing surgery. Hip resurfacing remains an emergent technology, with further follow-up and investigation warranted. One explanation for suboptimal recovery may be current rehabilitation, originally developed after total hip arthroplasty. Rehabilitation tailored to hip resurfacing, paced for this active population and progressed to higher demand activities, may improve outcomes.
Newman
Meredith A
MA
Physiotherapy Research Unit, Nuffield Orthopaedic Centre NHS Trust, Oxford, UK. Meredith.newman@noc.anglox.nhs.uk
Barker
Karen L
KL
Pandit
Hemant
H
Murray
David W
DW
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods* / Q000534:rehabilitation*; D015331:Cohort Studies; D005260:Female; D005271:Femur Head Necrosis / Q000175:diagnosis / Q000601:surgery; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D006620:Hip Fractures / Q000175:diagnosis / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000175:diagnosis / Q000601:surgery; D010147:Pain Measurement; D011183:Postoperative Complications / Q000601:surgery; D011474:Prosthesis Design; D011475:Prosthesis Failure; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function / Q000502:physiology; D012086:Reoperation; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D008670:Metals