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No benefit seen in hip resurfacing compared with THA
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SAN DIEGO — No major differences with regards to metal ion levels or functional outcomes were observed between patients who underwent hip resurfacing arthroplasty and those who underwent total hip arthroplasty, according to the results of a randomized controlled trial presented here, at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons.
The study, led by Job L.C. van Susante, MD, PhD, of Rijnstate Hospital Arnhem, the Netherlands, included 82 patients who were randomized to undergo resurfacing hip arthroplasty (RHA) with a Conserve Plus (Wright Medical Technology) or total hip arthroplasty (THA) with a 28-mm head (Zweymuller Metasul; Zimmer Orthopaedics). Among those patients, 68 patients have been followed up for more than 6 months.
Observing the limitations of this study, van Susante acknowledged the need for longer follow-up.
“We have a low patient number in this study … Patient recruitment appears to be extremely difficult from a patient’s preference for resurfacing. There is however a limited availability of randomized controlled trials, so this one will be important to follow up,” he said.
van Susante and colleagues measured cobalt and chromium ion levels preoperatively and at 3, 6, 12 and 24 months. Functional outcomes were assessed at those same intervals using the Oxford Hip score, Harris Hip score, SF-12 and UCLA activity score.
The investigators found that metal-ion rates were significantly higher in the HRA group during the first postoperative year, but leveled out after that. Median metal ion levels did not reach toxic levels in either group, according to van Susant.
Both groups experienced significantly better function and quality of life 12 months postoperatively; however, the UCLA activity score at 12 months was significantly higher in the HRA group.
“If you use the right implant and you select the right patient and you have experience with resurfacing, you can still achieve very good results. But, we should not forget that with a regular, conventional total hip arthroplasty we also reach very good results,” van Susant told ORTHOSuperSite.com.
Reference:
- van Susant JLC. Metal ions and outcome in resurfacing hip arthroplasty (RHA) versus total hip arthroplasty (THA). Paper #075. Presented at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons. Feb. 15-18, 2011. San Diego.
Disclosure: van Susant is on the speakers’ bureau and is a paid consultant for Wright Medical Technology, Inc. He has also received research or institutional support as a principal investigator from Zimmer and Wright Medical Technology, Inc.
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