Short and mid-term outcomes and functional results in metal-on-metal hip resurfacing arthroplasty at 5 years follow-up: the Spanish experience

Olga S. Pérez-Moro,Inmaculada Neira-Borrajo,Marcos E. Fernández-Cuadros,Eduvigis Aranda-Izquierdo,María J. Albaladejo-Florin,Rafael Llopis-Miró

doi:10.1186/s12891-019-2498-z

Olga S. Pérez-Moro, Inmaculada Neira-Borrajo + Show 4 more

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https://doi.org/10.1186/s12891-019-2498-z

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Abstract

BackgroundHip resurfacing arthroplasty (HRA) and in particular, Birmingham hip resurfacing (BHR), is commonly employed as an alternative to total hip arthroplasty (THA) in young patients, as it allows for preservation of femoral bone stock and resumption of physical activity. The aim of our study was to investigate 5-year survival and functional outcomes of BHR arthroplasty in young Spanish osteoarthritis (OA) patients.MethodsThis is an observational, prospective, cohort study of patients who underwent BHR between June 2005 and December 2009 at a Spanish public hospital with a minimum follow-up of 5 years. All surgeries were performed by a single surgeon (RLM). Survival was analyzed using the Kaplan-Meier method. Functional outcomes and return to work and physical activities were also assessed.ResultsFive-year survival rate of the prosthesis was 95.74% (95% CI: 95.77–98.07), and estimated 10-year survival was 92.92% (95% CI: 85.07–96.72). Harris hip score significantly increased from 41.13 to 97.63 (p < 0.001) at 5-year follow-up. Average time for returning to work and sporting activities was 3.89 (SD: 2.39) and 3.47 (SD: 1.18) months respectively. Failure occurred in 14 patients, 8 of whom experienced femoral neck fractures.ConclusionsOur data support the short and mid-term efficacy of BHR arthroplasty in young OA patients, indicating good implant survival, improvement in patients’ functionality and a swift return to work and physical activities after surgery.

Highlights

Hip resurfacing arthroplasty (HRA) and in particular, Birmingham hip resurfacing (BHR), is commonly employed as an alternative to total hip arthroplasty (THA) in young patients, as it allows for preservation of femoral bone stock and resumption of physical activity
Despite being a successful procedure, several studies have indicated that THA may not be the best option in younger patients, due to the higher rate of aseptic loosening and subsequent increased risk of revision surgery observed in this population [1,2,3,4]
When analyzing possible predictors of prosthesis failure, we found that higher body mass index (BMI) was associated with a significantly higher risk of failure (HR: 1.37; p = 0.008)

Summary

Introduction

Hip resurfacing arthroplasty (HRA) and in particular, Birmingham hip resurfacing (BHR), is commonly employed as an alternative to total hip arthroplasty (THA) in young patients, as it allows for preservation of femoral bone stock and resumption of physical activity. The aim of our study was to investigate 5-year survival and functional outcomes of BHR arthroplasty in young Spanish osteoarthritis (OA) patients. Total hip arthroplasty (THA) is regarded as an effective alternative in the treatment of patients with hip osteoarthritis (OA) [1]. In the late 70s (1979), hip resurfacing arthroplasty (HRA) attracted surgeons’ attention as a bone conserving alternative to THA for the treatment of young patients with OA [3]. The first generation of HRA prostheses was, associated with a high rate of wear, aseptic loosening (often secondary to osteolysis) and complications such as femoral neck fracture [7,8,9].

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