A DGReview of :”Metal-on-metal resurfacing of the hip in patients under the age of 55 years with osteoarthritis”
Journal of Bone and Joint Surgery. British Volume
By Mary Beth Nierengarten
Low early failure rates with the use of metal-on-metal hip resurfacing for hip replacement in young patients with osteoarthritis of the hip suggests the suitability of this procedure for young, active arthritic patients, reports a study from the United Kingdom.
Because conventional hip arthroplasty does not provide a lasting solution for young and active patients who require joint replacement, a less invasive procedure using metal-on-metal hip resurfacing has been used for nearly a decade in this setting…
In this study, J Daniel, MD, FRCS, Birmingham Nuffield Hospital, and colleagues assess early results obtained with metal-on-metal hip resurfacing of 446 hips in 384 patients between 1994 and 2001 (excluding 1996). All patients had primary osteoarthritis of the hip and were less than 55 years of age. Evaluation of outcome was based on survival rate, the Oxford Hip Scores to assess pain, mobility, and function, and the University of California Los Angeles (UCLA) Activity Level Scale to assess current activity levels.
Of the 384 patients, 6 died of unrelated causes during the study period and were excluded from the analysis. With a follow up from 1.1 to 8.2 years for the remaining 378 patients (439 hips), the survival rate was 99.8% and the median Oxford score was 12 (with 17 patients/19 hips having a score above the 95th percentile). Of the 369 patients who completed the UCLA Activity Level Scale, all scored a 5 or more that indicated an active life-style — 87% of the entire group are involved in sports, with 58.7% participating in sporting activities more than twice a week and 23.8% at least twice a week…