Vincent A. Fowble, MD, et al.
Bulletin of the NYU Hospital for Joint Diseases. June 2009. Vol. 67. No. 2. Pp. 108-112.
The authors of this study set up a study of 50 hips getting hip resurfacing and 44 hips undergoing conventional hip replacement. All procedures were done by one surgeon in the same hospital during a single time period.
The study was designed to look at patient demographics. A second measure used in the comparison was the preoperative clinical condition of the patient: joint range-of-motion, strength, and function. The results or final outcomes from the surgery were compared, and patients were followed for two to four years to give an idea of the mid-term results.
The patients having hip joint resurfacing were more often men, an average of three inches taller and 10 to 20 pounds lighter, and had arthritis only in one hip compared with the THR group. The hip resurfacing patients were in better overall, general health. They were also younger than the other group by 10 years.
Patients in both groups attended physical therapy and followed the same rehab program. Activities were not restricted and patients were told to do whatever they felt up to. According to the results of tests, the hip resurfacing group got better faster, had less pain right away and reported higher activity levels compared to the THR group.
A closer look at the two groups showed that the THR group gained more motion because their loss of motion before the surgery was so much greater than the hip resurfacing group. In the end, the two groups had the same hip motion in all directions. And although the hip resurfacing group got faster pain relief, they didn’t always get complete pain relief. More of the resurfacing patients reported pain during the follow-up period, whereas the THR patients were more likely to be pain-free by then. But that might also be because they were older and less active.
The results of this study support the continued careful selection of patients to have hip resurfacing. The good results may be more likely attributed to patient characteristics than to differences between resurfacing versus replacement. Statistical differences in joint motion and risk of dislocation weren’t observed.