Hip Resurfacing/Partial Hip Replacement
While many people associate joint replacements with older people, many younger people end up needing them as well. Unfortunately, this is one time when young age may actually work against someone. Many orthopedic surgeons are reluctant to do full hip replacements on patients who are under 50 years old because of their active lifestyles and life expectancy. These two factors can bring about the need to revise the hip replacement at a later date, causing another surgery. IN an effort to reduce the use of full replacements, surgeons are now doing a metal-on-metal sort of hybrid partial replacement, called resurfacing total hip arthropasty (THA). It appears to have a longer lasting outcome. This procedure doesn't involve the whole hip and is easier to remove than a full replacement, if needed.
The authors, believing that resurfacing THA is better for younger, active adults, compared the findings of patients below 50 years old with those over 50 years. The 576 patients in this study had a hybrid metal-on-metal resurfacing and were split into group 1, patients below 50 years (350 hips in 295 patients, average age was 41.2 years) and group 2, over 50 years of age (336 hips in 281 patients, average age was 57.4 years). Three quarters of the patients were men.
The patients were followed up at 6 weeks, 4 months, and 1 year, and yearly after that for x-rays. The researchers found no differences in the state of the hips between the patients in either group. Measurements using University of California Los Angeles (UCLA) hip scores showed an improvement for pain, walking, function, and activity, with no difference in ages. After 5 years, the survivorship of the bones was 97.8 percent, showing that the metal-on-metal resurfacing THA performed well.
The authors pointed out that metal-on-metal resurfacing THA is relative new still, only 10 years, so long-term results are not yet available.
Harlan C. Amstutz, MD, et al. Resurfacing THA for Patients Younger than 50 Years Old. In Clinical Orthopedics & Related Research. Vol. 460. Pp. 159-164.'