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Review
. 2025 Jun;17(6):1577-1588.
doi: 10.1111/os.70019. Epub 2025 Mar 16.

The Choice of Hip Arthroplasty: HRA or THA? Revealed by Meta-Analysis

Xiao Fan  1   2 , Yimin Zhou  3 , Tianyu Zhou  2 , Justin P Cobb  2 , Tengbo Yu  1
Affiliations
Review

The Choice of Hip Arthroplasty: HRA or THA? Revealed by Meta-Analysis

Xiao Fan et al. Orthop Surg. 2025 Jun.

Abstract

Background: Total hip arthroplasty (THA) is the gold standard for end-stage hip arthrosis, while hip resurfacing arthroplasty (HRA) is considered a more bone-conserving alternative. This meta-analysis aimed to compare the safety and clinical efficacy of HRA and THA.

Methods: The databases of PubMed, EMBASE, Cochrane Library, and CNKI were searched for RCTs comparing HRA and THA in treating hip arthrosis from database initiation to April 2024. Inclusion and exclusion criteria were defined, and data extraction, quality evaluation, and risk bias assessment were performed. A meta-analysis was conducted using appropriate RevManv5.4 and Stata v14.0 software.

Results: Twenty RCTs from six countries were included. HRA had a similar revision rate, function scores (WOMAC, HSS, OHS, UCLA activity score, EQ-D, EQ-5D VAS), and blood levels of cobalt and chromium compared to THA. HRA had fewer complications and less blood loss but required more operating time.

Conclusions: HRA is a safe and effective alternative to THA, with similar revision and functional outcomes, less blood loss, and is particularly suitable for young male patients with a demand for high-level activities.

Keywords: clinical efficacy; hip arthrosis; hip resurfacing arthroplasty (HRA); meta‐analysis; safety; systematic review; total hip arthroplasty (THA).

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart of document retrieval process.
FIGURE 2
FIGURE 2
Risk of bias assessment results included in RCTs (Cochrane Manual of Systematic Reviews).
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Revision rate.
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WOMAC.
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OHS.
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HHS.
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UCLA activity score.
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EQ‐5D.
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EQ‐5D VAS.
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Blood levels of cobalt.
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Blood levels of chromium.
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Complications.
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Blood loss.
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Operating time.
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Operation time subgroup.
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FIGURE 16
Complications funnel plot.
See this image and copyright information in PMC

References

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