Do revised hip resurfacing arthroplasties lead to outcomes comparable to those of primary and revised total hip arthroplasties?
BACKGROUND
A theoretical clinical advantage of hip resurfacing (HR) is the preservation of femoral bone. HR femoral component revision reportedly yields postoperative function comparable to that of primary THA. However, few studies have looked at the outcome of both HR femoral and acetabular side revisions.


OBJECTIVE
We determined whether (1) patients undergoing HR revision to THA have perioperative measures and outcome scores comparable to those of patients undergoing primary THA or revision of primary THA and (2) patients undergoing HR revision of both components have perioperative measures and outcome scores comparable to those of patients undergoing HR revision of the femoral component only.


METHODS
We retrospectively reviewed and compared 22 patients undergoing revision HR to a THA to a matched (age, sex, BMI) group of 23 patients undergoing primary THA and 12 patients undergoing primary THA revision. Patients completed the WOMAC and SF-12 questionnaires before surgery and at latest followup (range, 24-84 months for HR revision, 28-48 months for primary THA, and 24-48 months for revision THA). Blood loss, days in hospital, complications, and outcome scores were compared among groups.


RESULTS
We observed no differences in SF-12 scores but observed lower WOMAC stiffness, function, and total scores in the HR revision group than in the primary THA group. Patients undergoing HR revision of both components had comparable SF-12 and WOMAC stiffness, function, and total scores but overall lower WOMAC pain scores compared to patients undergoing HR revision of the femoral side only. The HR revision group had greater intraoperative blood loss compared to the primary THA group but not the revision THA group.


CONCLUSIONS
The perioperative measures and outcome scores of HR revision are comparable to those of revision THA but not primary THA. Longer followup is required to determine whether these differences persist. Patients undergoing HR revision of one or both components can expect comparable stiffness and function.


METHODS
Level IV, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.
Division of Orthopaedic Surgery, The Ottawa Hospital, 501 Smyth Road, Room W1646, Box 502, Ottawa, ON K1H 8L6, Canada.
William
W
Desloges
Isabelle
I
Catelas
Toru
T
Nishiwaki
Paul R
PR
Kim
Paul E
PE
Beaulé
D000077:Acetabulum / Q000601:surgery; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D001672:Biocompatible Materials; D005260:Female; D005269:Femur / Q000601:surgery; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome
D001672:Biocompatible Materials; D008670:Metals