CZ-SK Hip Resurfacing Group

Long-term Results THR in Young Patients

Recently I posted results and link to Mr. McMinn's recently published results for the BHR out to 15 years. It is useful to compare those results to what is often held up as the "gold standard", the cemented metal-on-plastic articulating total hip, which has a much longer history. When you look at such results it is best to consider the same patient group that is appropriate for hip resurfacing, the young and/or active patient. Just this month some long-term results for the Charnley cemented hip implanted in patients younger than 50 at time of surgery were published in the Journal of Bone and Joint Surgery. Fortunately the full text for this article is available for free to the general public, so I have placed a copy in the files section of the Surfacehippy Group web site:

http://www.surfacehippygroup.org/files/ ... llowup.pdf

In this paper the results of a series of 96 hips implanted in 69 patients by a single surgeon is tracked for 35 years. Figure 2 of the paper shows the survivorship of hips over 35 years. The end point shows a survivorship at 35 years of 63%. However, for followup that long, more than half the patients have died for a variety of unrelated reasons, some of whom died without having a revision. So, considering only those patients still living, the survivorship among those living is 46%.

No modern hip resurfacing device has a history that long, so we consider the survivorship results at 10 and 15 years. Recall McMinn had reported overall results of 97.4% at 10 years and 95.8% at 15 years. For the cemented metal-on-poly results the survivorship was about 90% at 10 years and just 79% at 15 years as the rate of revision accelerating in that 5 year period. If you consider the rate of revision at 10 years the traditional hip replacement had 3 times as many revisions in this patient population and at 15 years the revision rate is 5 times that of McMinn's first 1000 resurfacings.