Nathan Alloun, Pierre Martinot, Philippe-Alexandre Faure, Henri Migaud, Julien Girard
{"title":"30岁前接受全髋关节置换术或髋关节表面置换术患者的比较研究：9年随访的生存率、功能和活动评分","authors":"Nathan Alloun, Pierre Martinot, Philippe-Alexandre Faure, Henri Migaud, Julien Girard","doi":"10.1016/j.otsr.2025.104339","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Total hip arthroplasty (THA) remains relatively uncommon procedure in patients under the age of 30. Hip resurfacing (HR) is a potential alternative to THA. To our knowledge, no study has compared these two options in patients under 30 years old. Therefore, we conducted a retrospective comparative study of HR versus THA to: 1) assess implant survival, 2) evaluate functional outcomes.</p><p><strong>Hypothesis: </strong>HR provide better survival and superior functional and activity scores compared to THA.</p><p><strong>Materials and methods: </strong>Between 2006 and 2017, 105 patients under 30 years underwent either HR (62 cases) or THA (43 cases). We compared the number of surgical revisions and their causes to determine survival. Clinical outcomes were assessed using the following scores: Merle d'Aubigné, UCLA, Forgotten Joint Score (FJS), Oxford-12, Harris, and Devane. The Minimum Clinically Important Difference (MCID) and the Patient Acceptable Symptom State (PASS) were also analyzed using the Oxford-12 score.</p><p><strong>Results: </strong>After 8 years of follow-up, implant survival was 89.9% (95%CI: 0.71-0.96) in the THA group versus 98.4% (95%CI: 0.89-0.99) in the HR group. The THA group had three revisions (due to wear, metallosis, and infection), whereas the HR group had one (femoral collapse). Before adjusting for preoperative status, Harris and Devane scores were higher in the THA group: 96.8 (Interquartile Range (IQR): 92-100) vs 91.5 (IQR: 86-97) (p = 0.002) and 4 (IQR: 4-5) vs 4 (IQR: 3-5) (p = 0.003), respectively. After adjustment, THA patients showed significantly greater improvements in activity scores: Devane (0.5 vs. 0 (p = 0.0006)) and UCLA (1.2 vs. 0 (p = 0.0007)). No significant differences were observed between HR and THA regarding MCID or PASS based on Oxford-12.</p><p><strong>Discussion: </strong>HR allows for easier revision surgery and demonstrates excellent clinical outcomes, making it a valuable option in very young patients who are likely to require future surgeries. Our data confirm that HR is a viable long-term option for patients under 30 years old when technically feasible.</p><p><strong>Level of evidence: </strong>III; retrospective case-control study.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104339"},"PeriodicalIF":2.2000,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparative study of patients undergoing total hip arthroplasty or hip resurfacing before 30 years of age: Survivorship, Functional and Activity scores at 9-year follow-up.\",\"authors\":\"Nathan Alloun, Pierre Martinot, Philippe-Alexandre Faure, Henri Migaud, Julien Girard\",\"doi\":\"10.1016/j.otsr.2025.104339\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Total hip arthroplasty (THA) remains relatively uncommon procedure in patients under the age of 30. Hip resurfacing (HR) is a potential alternative to THA. To our knowledge, no study has compared these two options in patients under 30 years old. Therefore, we conducted a retrospective comparative study of HR versus THA to: 1) assess implant survival, 2) evaluate functional outcomes.</p><p><strong>Hypothesis: </strong>HR provide better survival and superior functional and activity scores compared to THA.</p><p><strong>Materials and methods: </strong>Between 2006 and 2017, 105 patients under 30 years underwent either HR (62 cases) or THA (43 cases). We compared the number of surgical revisions and their causes to determine survival. Clinical outcomes were assessed using the following scores: Merle d'Aubigné, UCLA, Forgotten Joint Score (FJS), Oxford-12, Harris, and Devane. The Minimum Clinically Important Difference (MCID) and the Patient Acceptable Symptom State (PASS) were also analyzed using the Oxford-12 score.</p><p><strong>Results: </strong>After 8 years of follow-up, implant survival was 89.9% (95%CI: 0.71-0.96) in the THA group versus 98.4% (95%CI: 0.89-0.99) in the HR group. The THA group had three revisions (due to wear, metallosis, and infection), whereas the HR group had one (femoral collapse). Before adjusting for preoperative status, Harris and Devane scores were higher in the THA group: 96.8 (Interquartile Range (IQR): 92-100) vs 91.5 (IQR: 86-97) (p = 0.002) and 4 (IQR: 4-5) vs 4 (IQR: 3-5) (p = 0.003), respectively. After adjustment, THA patients showed significantly greater improvements in activity scores: Devane (0.5 vs. 0 (p = 0.0006)) and UCLA (1.2 vs. 0 (p = 0.0007)). No significant differences were observed between HR and THA regarding MCID or PASS based on Oxford-12.</p><p><strong>Discussion: </strong>HR allows for easier revision surgery and demonstrates excellent clinical outcomes, making it a valuable option in very young patients who are likely to require future surgeries. Our data confirm that HR is a viable long-term option for patients under 30 years old when technically feasible.</p><p><strong>Level of evidence: </strong>III; retrospective case-control study.</p>\",\"PeriodicalId\":54664,\"journal\":{\"name\":\"Orthopaedics & Traumatology-Surgery & Research\",\"volume\":\" \",\"pages\":\"104339\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-07-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Orthopaedics & Traumatology-Surgery & Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.otsr.2025.104339\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Orthopaedics & Traumatology-Surgery & Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.otsr.2025.104339","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
摘要
在30岁以下的患者中，全髋关节置换术（THA）仍然是相对罕见的手术。髋关节表面置换（HR）是THA的潜在替代方案。据我们所知，在30岁以下的患者中，没有研究比较过这两种选择。因此，我们进行了一项HR与THA的回顾性比较研究，目的是：1)评估植入物存活，2)评估功能结果。假设：与THA相比，HR提供更好的生存和更好的功能和活动评分。材料和方法：2006年至2017年，105例30岁以下患者接受了HR（62例）或THA（43例）。我们比较了手术修复的次数及其原因，以确定生存率。临床结果采用以下评分进行评估：Merle d’aubign、UCLA、遗忘关节评分（FJS）、Oxford-12、Harris和Devane。最小临床重要差异（MCID）和患者可接受症状状态（PASS）也使用Oxford-12评分进行分析。结果：8年随访后，THA组种植体成活率为89.9% (95%CI: 0.71-0.96)， HR组为98.4% （95%CI: 0.89-0.99）。THA组有三次翻修（由于磨损、金属病和感染），而HR组只有一次翻修（股塌陷）。在调整术前状态之前，Harris和Devane评分在THA组更高：96.8（四分位间距（IQR）： 92-100） vs 91.5 (IQR: 86-97) （p = 0.002）和4 (IQR: 4-5) vs 4 (IQR: 3-5) （p = 0.003）。调整后，THA患者在活动评分方面的改善明显更大：Devane （0.5 vs. 0 (p = 0.0006)）和UCLA （1.2 vs. 0 (p = 0.0007)）。HR和THA在基于Oxford-12的MCID或PASS方面无显著差异。讨论：HR允许更容易的翻修手术，并证明了良好的临床效果，使其成为非常年轻的患者可能需要未来手术的一个有价值的选择。我们的数据证实，在技术可行的情况下，HR是30岁以下患者的一个可行的长期选择。证据等级：III；回顾性病例对照研究。
Comparative study of patients undergoing total hip arthroplasty or hip resurfacing before 30 years of age: Survivorship, Functional and Activity scores at 9-year follow-up.
Introduction: Total hip arthroplasty (THA) remains relatively uncommon procedure in patients under the age of 30. Hip resurfacing (HR) is a potential alternative to THA. To our knowledge, no study has compared these two options in patients under 30 years old. Therefore, we conducted a retrospective comparative study of HR versus THA to: 1) assess implant survival, 2) evaluate functional outcomes.
Hypothesis: HR provide better survival and superior functional and activity scores compared to THA.
Materials and methods: Between 2006 and 2017, 105 patients under 30 years underwent either HR (62 cases) or THA (43 cases). We compared the number of surgical revisions and their causes to determine survival. Clinical outcomes were assessed using the following scores: Merle d'Aubigné, UCLA, Forgotten Joint Score (FJS), Oxford-12, Harris, and Devane. The Minimum Clinically Important Difference (MCID) and the Patient Acceptable Symptom State (PASS) were also analyzed using the Oxford-12 score.
Results: After 8 years of follow-up, implant survival was 89.9% (95%CI: 0.71-0.96) in the THA group versus 98.4% (95%CI: 0.89-0.99) in the HR group. The THA group had three revisions (due to wear, metallosis, and infection), whereas the HR group had one (femoral collapse). Before adjusting for preoperative status, Harris and Devane scores were higher in the THA group: 96.8 (Interquartile Range (IQR): 92-100) vs 91.5 (IQR: 86-97) (p = 0.002) and 4 (IQR: 4-5) vs 4 (IQR: 3-5) (p = 0.003), respectively. After adjustment, THA patients showed significantly greater improvements in activity scores: Devane (0.5 vs. 0 (p = 0.0006)) and UCLA (1.2 vs. 0 (p = 0.0007)). No significant differences were observed between HR and THA regarding MCID or PASS based on Oxford-12.
Discussion: HR allows for easier revision surgery and demonstrates excellent clinical outcomes, making it a valuable option in very young patients who are likely to require future surgeries. Our data confirm that HR is a viable long-term option for patients under 30 years old when technically feasible.
Level of evidence: III; retrospective case-control study.
期刊介绍：
Orthopaedics & Traumatology: Surgery & Research (OTSR) publishes original scientific work in English related to all domains of orthopaedics. Original articles, Reviews, Technical notes and Concise follow-up of a former OTSR study are published in English in electronic form only and indexed in the main international databases.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
