Resurfacing versus conventional total hip arthroplasty - review of comparative clinical and basic science studies.
OBJECTIVE
Although standard total hip arthroplasties have a long and successful history as the standard of care for advanced, symptomatic osteoarthritis, there is increasing patient demand and surgeon interest in femoral bone conserving resurfacing alternatives. The purpose of this study was to assess the state of the research that directly compares the outcomes of conventional total hip arthroplasty procedures with the current generation of metal-on-metal resurfacing hip arthroplasties.


METHODS
A comprehensive review was performed of the published literature that directly compared total hip arthroplasty and resurfacing hip arthroplasty and that considered basic science, radiographic, and clinical studies.


RESULTS
Of the basic science studies, two investigations found evidence that favored total hip arthroplasty, while three favored resurfacing hip arthroplasty. For the clinical studies, all reports showed that resurfacing hip arthroplasty had similar or better outcomes than total hip arthroplasty at short- to midterm follow-up. The gait studies suggest that resurfacing provides a more natural gait than conventional total hip arthroplasty.


CONCLUSIONS
While there is still much debate and room for additional research on this topic, multiple midterm clinical results suggest that resurfacing hip arthroplasty represents a safe, effective alternative to conventional total hip arthroplasty, especially for younger, active patients.
Marker
David R
DR
Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD, USA.
Strimbu
Kyle
K
McGrath
Mike S
MS
Zywiel
Michael G
MG
Mont
Michael A
MA
D000818:Animals; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D001696:Biomechanical Phenomena; D005684:Gait; D006621:Hip Joint / Q000503:physiopathology / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008670:Metals; D019060:Minimally Invasive Surgical Procedures; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control; D018579:Patient Selection; D011474:Prosthesis Design; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012086:Reoperation; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
D008670:Metals