title: Do young, active patients perceive advantages after surface replacement compared to cementless total hip arthroplasty?
abstract: BACKGROUND
  Potential advantages suggested but not confirmed for surface replacement arthroplasty (SRA) over THA include lower frequency of limp, less thigh pain, less limb length discrepancy, and higher activity.
  
  
  OBJECTIVE
  We therefore determined whether patients having SRA had a limp, thigh pain, or limb length discrepancy less frequently or had activity levels higher than patients having THA.
  
  
  METHODS
  In a multicenter study, we surveyed 806 patients aged 18 to 60 years with a premorbid UCLA activity score of 6 or more who underwent hip arthroplasty for noninflammatory arthritis at one of five orthopaedic centers. Patients had either a cementless THA with an advanced bearing surface (n = 682) or an SRA (n = 124). The patients were demographically comparable. Specific telephone survey instruments were designed to assess limp, thigh pain, perception of limb length, and activity levels. Minimum followup was 1 year (mean, 2.3 years; range, 1.1-3.9 years).
  
  
  RESULTS
  When controlled for age, sex, and premorbid activity level, patients with SRA had a higher incidence of complete absence of any limp, lower incidence of thigh pain, lower incidence of perception of limb length discrepancy, greater ability to walk continuously for more than 60 minutes, higher percentage of patients who ran after surgery, greater distance run, and higher percentage of patients who returned to their most favored recreational activity.
  
  
  CONCLUSIONS
  When interviewed by an independent third party, patients with SRA reported higher levels of function with fewer symptoms and less perception of limb length discrepancy compared to a similar cohort of young, active patients with THA.
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine/Barnes-Jewish Hospital, Washington University School of Medicine, One Barnes-Jewish Hospital Plaza, 11300 West Pavilion, Campus Box 8233, St Louis, MO, 63110, USA, barrackr@wustl.edu.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Barrack
authors.forename: Erin L
authors.initials: EL
authors.lastname: Ruh
authors.forename: Michael E
authors.initials: ME
authors.lastname: Berend
authors.forename: Craig J
authors.initials: CJ
authors.lastname: Della Valle
authors.forename: C Anderson
authors.initials: CA
authors.lastname: Engh
authors.forename: Javad
authors.initials: J
authors.lastname: Parvizi
authors.forename: John C
authors.initials: JC
authors.lastname: Clohisy
authors.forename: Ryan M
authors.initials: RM
authors.lastname: Nunley
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D001843:Bone Cements; D005260:Female; D006621:Hip Joint / Q000503:physiopathology / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D020127:Recovery of Function / Q000502:physiology; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements