title: Hip resurfacing arthroplasty: time to consider it again? No.
abstract: Total hip arthroplasty (THA) is one of the most successful operations in orthopaedics. A new procedure designed to replace THA, such as hip resurfacing arthroplasty, even for select indications, must offer a definite improvement over the well-established gold standard of treatment. Hip resurfacing does not currently meet this standard. THA is a proven and durable procedure with excellent results and superior short-term implant survival compared with hip resurfacing arthroplasty. Patients treated with hip resurfacing arthroplasty incur unique risks associated with implant malpositioning resulting from the surgeons' steep learning curve, the complex instrumentation involved, and the technical difficulty of the procedure, as well as a risk of femoral neck fracture. Hip resurfacing has limited ability to appropriately restore hip biomechanics and limb length, and concerns for the effects of metal ion and potential revision challenges remain. To date, there is a lack of literature supporting the claim of superior functional outcomes in hip resurfacing compared with THA. Reconsideration of hip resurfacing arthroplasty is unwarranted until appropriate comparative studies can demonstrate a clear benefit to patients.
authors.affiliation: Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: James D
authors.initials: JD
authors.lastname: Slover
authors.forename: Harry E
authors.initials: HE
authors.lastname: Rubash
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D006801:Humans; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography