title: Two Year Clinical Outcomes of Total Hip Arthroplasty Are Not Dependent on Femoral Head Composition.
abstract: BACKGROUND
  Assessment of clinical outcomes and patient quality of life after total hip arthroplasty continues to grow in importance with the focus on how bearing surfaces affect long-term survival, wear, and cost. Further, as quality measures have become incorporated into reimbursement, there is a need to quantify factors which may influence these outcomes. Currently, there is a paucity of literature regarding the effects of the femoral head composition on clinical outcomes or quality of life.
  
  
  OBJECTIVE
  We sought to determine if any difference in quality of life measures could be detected in patients treated with total hip replacement implanted with cobalt-chrome (CoCr) versus ceramic femoral heads at 2-year follow-up.
  
  
  METHODS
  We compared the hip disability and osteoarthritis outcome score (HOOS) and EuroQOL (EQ5D) scores of a matched set of patients that underwent primary total hip arthroplasty with highly cross-linked polyethylene (HXLPE) and a single implant system consisting of either a metal or a ceramic femoral head.
  
  
  RESULTS
  Clinical outcomes and quality of life improved for both groups after hip replacement surgery. Patients with a ceramic head showed greater improvement than those with a metal head in HOOS pain and EQ5D VAS scores by a statistically significant margin (p = 0.0417 and 0.019, respectively), but the differences between the HOOS and EQ5D VAS scores (3.4 and 0.04, respectively) do not demonstrate a clinically significant difference.
  
  
  CONCLUSIONS
  We found that the femoral head composition has no effect on clinical outcomes or patient quality of life at 2 years.
authors.affiliation: Division of Adult Reconstruction and Joint Replacement Surgery, Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Ast
authors.affiliation: Hospital for Special Surgery, New York, NY USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Lyman
authors.affiliation: Division of Adult Reconstruction and Joint Replacement Surgery, Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
authors.forename: Alexandra H
authors.initials: AH
authors.lastname: Gorab
authors.affiliation: Division of Adult Reconstruction and Joint Replacement Surgery, Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
authors.forename: Natalie
authors.initials: N
authors.lastname: Parkes
authors.affiliation: Division of Adult Reconstruction and Joint Replacement Surgery, Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
authors.forename: John
authors.initials: J
authors.lastname: Boles
authors.affiliation: Hospital for Special Surgery, New York, NY USA.
authors.forename: Yuo-Yu
authors.initials: YY
authors.lastname: Lee
authors.affiliation: Division of Adult Reconstruction and Joint Replacement Surgery, Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
authors.forename: Geoffrey H
authors.initials: GH
authors.lastname: Westrich
keywords: EQ5D; THA; arthroplasty; ceramic; clinical outcomes; femoral head; metal; quality of life