Hip resurfacing arthroplasty: risk factors for failure over 25 years.
Many early metal-on-polyethylene hip resurfacing arthroplasty designs were abandoned after reports of high short-term and midterm failure rates. To investigate factors associated with failure, we retrospectively reviewed our experience with early-design hip resurfacing implants in 75 patients during a 25-year period (median followup, 7.9 years; range, 0.1-25.2 years). Implant failure was defined as revision for any reason. One of 75 patients was lost to followup. The estimated rate of implant survival was 73% at 5 years, 34% at 10 years, 27% at 15 years, 12% at 20 years, and 8% at 25 years. Of the many clinical and radiographic factors considered, only age, implant type, and gender were associated with implant survival independent of other variables considered. Hip resurfacing arthroplasty showed poor overall long-term survival in this series. Particular attention should be paid to the identified risk factors as long-term followup data become available for modern designs.


METHODS
Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Yue
Eric J
EJ
Department of Orthopedic Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA.
Cabanela
Miguel E
ME
Duffy
Gavan P
GP
Heckman
Michael G
MG
O'Connor
Mary I
MI
D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D025981:Hip Injuries / Q000175:diagnosis / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult