The John Charnley Award: The functional outcome of hip resurfacing and large-head THA is the same: a randomized, double-blind study.
Better functional outcome is believed by some to occur after hip resurfacing (HR) than conventional 28-mm total hip arthroplasty (THA) in young and active patients with hip osteoarthritis. However, the postulated superior outcome of HR over THA may simply be the result of a bias in patient selection or the use of a larger femoral head. We therefore asked whether HR would demonstrate superior functional outcome when compared with a THA with a large-diameter femoral head in a randomized, double-blind study. Gait speed and postural balance evaluations, functional tests, and clinical data were analyzed preoperatively and at 3, 6, and 12 months after surgery. Gait speed was used as the primary outcome measure. Forty-eight patients were randomized in the study and a third group of 14 healthy subjects served as controls. The gait speed and postural balance evaluations, the performance at most functional tests, and clinical scores were similar in HR and large-head THA groups at each followup period. The operated patients reached most control group values at 3 months postoperatively. By these measures, HR did not provide better clinical function over large-head THA.


METHODS
Level I, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Lavigne
Martin
M
Maisonneuve-Rosemont Hospital, 5415 Assomption Boulevard, Montreal, Quebec, H1T 2M4, Canada. lavigma2@hotmail.com
Therrien
Marc
M
Nantel
Julie
J
Roy
Alain
A
Prince
François
F
Vendittoli
Pascal-André
PA
D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D001363:Awards and Prizes; D004311:Double-Blind Method; D005260:Female; D005684:Gait; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D007592:Joint Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D004856:Postural Balance; D011474:Prosthesis Design; D011859:Radiography; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome