Comparison of Patient-Reported Outcome from Neck-Preserving, Short-Stem Arthroplasty and Resurfacing Arthroplasty in Younger Osteoarthritis Patients

Abstract

Hip resurfacing has been considered a good treatment option for younger, active osteoarthritis patients. However, there are several identified issues concerning risk for neck fractures and issues related to current metal-on-metal implant designs. Neck-preserving short-stem implants have been discussed as a potential alternative, but it is yet unclear which method is better suited for younger adults. We compared hip disability and osteoarthritis outcome scores (HOOS) from a young group of patients (n = 52, age 48.9 ± 6.1 years) who had received hip resurfacing (HR) with a cohort of patients (n = 73, age 48.2 ± 6.6 years) who had received neck-preserving, short-stem implant total hip arthroplasty (THA). Additionally, durations for both types of surgery were compared. HOOS improved significantly preoperatively to last followup (>1 year) in both groups (p < 0.0001, η (2) = 0.69); there were no group effects or interactions. Surgery duration was significantly longer for resurfacing (104.4 min ± 17.8) than MiniHip surgery (62.5 min ± 14.8), U = 85.0, p < 0.0001, η (2) = 0.56. The neck-preserving short-stem approach may be preferable to resurfacing due to the less challenging surgery, similar outcome, and controversy regarding resurfacing implant designs.

Figure 1

(a) HR implant, (b) traditional implant, and (c) neck-preserving, short-stem implant (Corin MiniHip). Most bone tissue is retained with HR (femoral head and neck, no significant intrusion of the femoral canal), whereas parts of the femoral neck are also preserved with the MiniHip approach.

Figure 2

Comparison of presurgery and postsurgery HOOS (scale of 0–100) means (and standard error) and duration of surgery (in minutes) in MiniHip and resurfacing arthroplasty. Independent of surgery type, all subscale scores improved after surgery. The only group differences were found in comparison of surgery duration. ^∗∗ p < 0.0001.