Excellent short-term results of hip resurfacing in a selected population of young patients - 06/10/15
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Abstract |
Background |
Hip resurfacing (HR) is an alternative option to total hip arthroplasty (THA) in a population of selected patients (young and/or active).
Hypothesis |
The short-term survivorship rate is as least as good as that for THA with no abnormal increase in serum metal ion levels.
Materials and 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 0.24μg/L (0.01–3.6) to 0.86μg/L (0.01–5.7) at the final follow-up (P<0.001). Chrome and titanium levels went from 0.68μg/L (0.01–4.4) and 2.36μg/L (0.39–7) to 1.28μg/L (0.1–5.5) and 4.49μg/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).
Discussion |
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 48mm and good quality femoral bone.
Level of evidence |
IV.
Le texte complet de cet article est disponible en PDF.Keywords : Femoral head diameter, Hip resurfacing, Ion levels, Survival
Plan
Vol 101 - N° 6
P. 661-665 - octobre 2015 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.