title: Metal-on-metal hip resurfacing compared with total hip arthroplasty: two to five year outcomes in men younger than sixty five years.
abstract: OBJECTIVE
  There are limited studies examining the long-term survivorship for the current generation of metal-on-metal hip resurfacing (MOMHR) implants in the young male population, and fewer studies have been published on prospectively collected outcomes data for total hip resurfacing in the USA. The purpose of this study was to demonstrate the efficacy of MOMHR in comparison with total hip arthroplasty (THA) using validated outcome measures, survivorship and complication rates.
  
  
  METHODS
  The study prospectively followed 136 implants in 123 male patients <65 years, all with a primary diagnosis of osteoarthritis and similar comorbidities as determined by the American Society of Anesthesiologists (ASA) score. A single-surgeon cohort of 89 MOMHRs was compared with a similar cohort of 47 THAs. Outcomes were prospectively assessed with the Short-Form Health Survey of 12 questions (SF-12) and Western Ontario and McMaster Universities (WOMAC) questionnaires pre- and postoperatively at yearly intervals. Minimum follow-up was two years, and average follow-up was 3.9 years.
  
  
  RESULTS
  Diagnosis, body mass index (BMI), American Association of Anesthesiologists (ASA) and pre-operative pain and function scores were not significantly different between groups. There was no difference in SF-12 scores postoperatively. At one and two years postoperatively, the MOMHR group had better WOMAC scores than the THA group, but no difference was seen at three to five years postoperatively. There were no revisions in either group over the study period.
  
  
  CONCLUSIONS
  This study demonstrated good results for hip resurfacing in men <65 years five years postoperatively and similar function to THA patients.
authors.affiliation: Center for Hip and Knee Replacement (CHKR), Department of Orthopaedic Surgery, NewYork-Presbyterian Hospital, Columbia University Medical Center, 622 W. 168th Street, PH 1155, New York, NY, 10032, USA, laf2108@columbia.edu.
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Fink Barnes
authors.forename: Skylar H
authors.initials: SH
authors.lastname: Johnson
authors.forename: David A
authors.initials: DA
authors.lastname: Patrick
authors.forename: William
authors.initials: W
authors.lastname: Macaulay
mesh_terms: D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D015992:Body Mass Index; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D061825:Metal-on-Metal Joint Prostheses; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000601:surgery; D010147:Pain Measurement; D011446:Prospective Studies; D011795:Surveys and Questionnaires