title: High revision rate at 5 years after hip resurfacing with the Durom implant.
abstract: BACKGROUND
  There is growing evidence that different resurfacing implants are associated with variable survival and revision rates. A registry analysis indicated the Durom resurfacing implant had high revision rates at 5 years, whereas three original studies reported low revision rates at short-term followups. Thus, the revision rates appear controversial.
  
  
  OBJECTIVE
  We therefore assessed (1) the survivorship including differences between women and men at a mean of 5 years after resurfacing with the Durom implant, and (2) clinical scores and radiographic parameters.
  
  
  METHODS
  We prospectively followed all 100 Durom hip resurfacings implanted in 91 patients (25 women and 66 men; mean age, 52 years) between 2003 and 2004. Survivorship analysis was performed with pending revision or revision for any reason as the endpoint. The minimum followup was 47 months (mean, 60 months; range, 47-72 months).
  
  
  RESULTS
  At a mean of 5 years, 11 hips were revised for various reasons. Cumulative survival was 88.2% for all patients and 81.5% for women. The mean Oxford (OHS) and Harris hip (HHS) scores were 14.6 and 94.7, respectively. The mean UCLA activity level was 7.9. Sclerotic changes around the short femoral stem (pedestal sign) were detected in 40% of the hips. We observed considerable femoral neck thinning with component-to-neck ratios of 0.85 preoperatively and 0.82 at 5 years.
  
  
  CONCLUSIONS
  Our study highlights a high revision rate 5 years after hip resurfacing with the Durom implant. This observation underlines previous findings from registry data and suggests that revision rates increase with time.
  
  
  METHODS
  Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopaedic Surgery, Schulthess Clinic, Lengghalde 2, 8008 Zurich, Switzerland. florian.naal@gmail.com
authors.forename: Florian D
authors.initials: FD
authors.lastname: Naal
authors.forename: Ronny
authors.initials: R
authors.lastname: Pilz
authors.forename: Urs
authors.initials: U
authors.lastname: Munzinger
authors.forename: Otmar
authors.initials: O
authors.lastname: Hersche
authors.forename: Michael
authors.initials: M
authors.lastname: Leunig
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation*; D001696:Biomechanical Phenomena; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012086:Reoperation; D013499:Surface Properties; D013557:Switzerland; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult