Hip Resurfacing Arthroplasty in Men: A Minimum 15-Year Follow-Up Study.

Abstract

Background: Hip resurfacing arthroplasty (HRA) has emerged as an alternative to total hip arthroplasty (THA) for managing osteoarthritis, particularly in younger, active men. However, long-term data on HRA outcomes in the United States remains limited.

Methods: We retrospectively examined 472 consecutive HRA cases in 407 men performed between January 2006 and December 2008 with a minimum 15-year follow-up outcomes. Patient-reported outcome measures (PROMs), including the modified Harris Hip Score (mHHS), Hip Disability and Osteoarthritis Outcome Score for Joint Replacement (HOOS-JR), Visual Analog Scale (VAS) for pain, and University of California-Los Angeles (UCLA) Activity Scale, were collected. Serum metal ion levels, survivorship, and radiographic outcomes were also assessed. Kaplan-Meier survival analysis was performed to evaluate implant survivorship. The mean follow-up was 16.0 years (range, 15.0 to 18.4).

Results: The overall survivorship at 15 years was 95.1%. Implants with femoral head sizes ≥ 48 mm demonstrated 95.8% survivorship, while those < 48 mm showed 91.3% survivorship. For unrevised hips, mean final follow-up scores were HOOS-JR 97.8 ± 5.6, mHHS 97.3 ± 6.4, VAS 0.4 ± 1.1, and UCLA Activity 8.0 ± 1.9. The median serum metal ion levels at the final follow-up were 2.3 μg/L for chromium and 1.7 μg/L for cobalt. There were 26 revisions that occurred, with aseptic loosening being the most common cause (n = 11).

Conclusion: This study demonstrates that HRA is a viable long-term solution for appropriately selected men with high survivorship and positive functional outcomes at a minimum 15-year follow-up.