title: Excellent short-term results of hip resurfacing in a selected population of young patients.
abstract: BACKGROUND
  Hip resurfacing (HR) is an alternative option to total hip arthroplasty (THA) in a population of selected patients (young and/or active).
  
  
  OBJECTIVE
  The short-term survivorship rate is as least as good as that for THA with no abnormal increase in serum metal ion levels.
  
  
  METHODS
  A continuous prospective series of 502 hip resurfacings in 481 patients mean age 48.7 years old (±10.3; 18-68) (Conserve Plus, Wright Medical Technology) was analyzed clinically, radiologically and biologically (total blood chrome, cobalt and titanium metal ion levels). Mean follow up was 4.1 years (1.9-4.9).
  
  
  RESULTS
  There were no dislocations. There were 5 cases of revision surgery with component replacement (including 2 infections). Implant survivorship using implant removal as the criteria (excluding infection) was 99.4% at 4 years (CI 95%: 98.1-99.8). The evaluation of metal ion levels showed a significant increase in cobalt from a preoperative level of 0.24 μg/L (0.01-3.6) to 0.86 μg/L (0.01-5.7) at the final follow-up (P<0.001). Chrome and titanium levels went from 0.68 μg/L (0.01-4.4) and 2.36 μg/L (0.39-7) to 1.28 μg/L (0.1-5.5) and 4.49 μg/L (1.29-8.21) respectively (P<0.001). All clinical scores had significantly improved at the final follow-up. Mean frontal plane cup inclination was 42.7° (35-62).
  
  
  CONCLUSIONS
  In a selected population of young and/or active patients, the short-term results of hip resurfacing are excellent. At the postoperative 4-year follow-up the rate of complications (in particular the absence of dislocations) was less than that for THA in young and/or active patients. Certain conditions must be respected to obtain these results; frontal plane cup inclination of between 40 and 45°, a femoral head diameter of at least 48 mm and good quality femoral bone.
  
  
  METHODS
  IV.
authors.affiliation: Université Lille Nord de France, 59000 Lille, France; Service d'orthopédie C, hôpital Salengro, place de Verdun, CHU de Lille, 59000 Lille, France.
authors.forename: A
authors.initials: A
authors.lastname: Lons
authors.affiliation: Université Lille Nord de France, 59000 Lille, France; Service d'orthopédie D, hôpital Salengro, place de Verdun, CHU de Lille, 59000 Lille, France.
authors.forename: A
authors.initials: A
authors.lastname: Arnould
authors.affiliation: Université Lille Nord de France, 59000 Lille, France; Service d'orthopédie C, hôpital Salengro, place de Verdun, CHU de Lille, 59000 Lille, France.
authors.forename: T
authors.initials: T
authors.lastname: Pommepuy
authors.affiliation: Université Lille Nord de France, 59000 Lille, France; Unité biostatistiques pôle santé publique, maison régionale de la recherche clinique, CERIM, 154, rue du Docteur-Yersin, 59000 Lille, France.
authors.forename: E
authors.initials: E
authors.lastname: Drumez
authors.affiliation: Université Lille Nord de France, 59000 Lille, France; Département de médecine du sport, faculté de médecine de Lille, université de Lille 2, Lille, France; Service d'orthopédie C, hôpital Salengro, place de Verdun, CHU de Lille, 59000 Lille, France. Electronic address: j_girard_lille@yahoo.fr.
authors.forename: J
authors.initials: J
authors.lastname: Girard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D061825:Metal-on-Metal Joint Prostheses; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery*; D011446:Prospective Studies; D012086:Reoperation; D016896:Treatment Outcome; D055815:Young Adult
keywords: Femoral head diameter; Hip resurfacing; Ion levels; Survival