Hip resurfacing arthroplasty as an alternative to total hip arthroplasty in patients aged under 40 years.

Autor:	Ramkumar PN; Hip Preservation Service, Hospital for Special Surgery, New York, New York, USA.; Long Beach Orthopaedic Institute, Long Beach, California, USA., Shaikh HJF; Department of Orthopaedic Surgery, Rochester, University of Rochester Medical Center, Rochester, New York, USA., Woo JJ; Department of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, Providence, Rhode Island, USA., Haeberle HS; Hip Preservation Service, Hospital for Special Surgery, New York, New York, USA., Pang M; Department of Orthopaedic Surgery, Harvard Medical School, Cambridge, Massachusetts, USA., Brooks PJ; Cleveland Clinic Florida, Weston, Florida, USA.
Jazyk:	angličtina
Zdroj:	Bone & joint open [Bone Jt Open] 2023 Jun 01; Vol. 4 (6), pp. 408-415. Date of Electronic Publication: 2023 Jun 01.
DOI:	10.1302/2633-1462.46.BJO-2023-0015.R1
Abstrakt:	Aims: The aims of the study were to report for a cohort aged younger than 40 years: 1) indications for HRA; 2) patient-reported outcomes in terms of the modified Harris Hip Score (HHS); 3) dislocation rate; and 4) revision rate. Methods: This retrospective analysis identified 267 hips from 224 patients who underwent an hip resurfacing arthroplasty (HRA) from a single fellowship-trained surgeon using the direct lateral approach between 2007 and 2019. Inclusion criteria was minimum two-year follow-up, and age younger than 40 years. Patients were followed using a prospectively maintained institutional database. Results: A total of 217 hips (81%) were included for follow-up analysis at a mean of 3.8 years. Of the 23 females who underwent HRA, none were revised, and the median head size was 46 mm (compared to 50 mm for males). The most common indication for HRA was femoroacetabular impingement syndrome (n = 133), and avascular necrosis ( (n = 53). Mean postoperative HHS was 100 at two and five years. No dislocations occurred. A total of four hips (1.8%) required reoperation for resection of heterotopic ossification, removal of components for infection, and subsidence with loosening. The overall revision rate was 0.9%. Conclusion: For younger patients with higher functional expectations and increased lifetime risk for revision, HRA is an excellent bone preserving intervention carrying low complication rates, revision rates, and excellent patient outcomes without lifetime restrictions allowing these patients to return to activity and sport. Thus, in younger male patients with end-stage hip disease and higher demands, referral to a high-volume HRA surgeon should be considered. Competing Interests: P. J. Brooks reports royalties or licenses, whereby the author licensed mushroom templates to Smith & Nephew (instruments used in the procedure), and being a consultant for Smith & Nephew, which is related to this work. P. N. Ramkumar declares consulting fees from Stryker and Globus, royalties from Globus, support for attending meetings and/or travel from Stryker and Arthrex, and stock or stock options from Intelligent Health Analytics Inc., Overture Resurfacing, Johnson & Johnson, and Conformis, all of which is unrelated to this article. (© 2023 Author(s) et al.)
Databáze:	MEDLINE
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