Hip Resurfacing and Sports in Total Joint Arthroplasty

Hip Resurfacing and Sports in Total Joint Arthroplasty

2012 AAOS: Balancing the Hype

Does the patient know best? Sports and satisfaction after total hip arthroplasty. 
Author: Parker et al.

Many patients expect to recovery normal hip function after total hip arthroplasty (THA) and often return to the sports they enjoyed prior to surgery. Surgeons have recommended against participation in many of these demanding activities because of their risk to the patient and to implant survival. High-demand patients seem to be aware of persistent symptoms yet are satisfied to maintain an active lifestyle.

The relationship of sporting activity and survivorship after hip resurfacing. 
Author: Amstutz et al.

The effect of sports on the durability of prostheses after hip resurfacing has not been studied. This study correlates the sporting activity levels computed as impact and cycle scores (ICS) with the survivorship of the procedure.

Conclusion: High levels of sporting activities can be detrimental to the long-term success of hip resurfacing arthroplasty, independently from other risk factors. Patients seeking hip resurfacing are usually young and should limit their involvement in sports to levels that the construct will be able to sustain.

Hip resurfacing vs. cementless large-diameter total hip arthroplasty – prospective randomized clinical trial. 
Author: Remes et al.

Advocates of hip resurfacing believe it has several theoretical advantages; bone stock preservation on the femoral side, more physiologic loading of the proximal femur, a low risk of dislocation due to large head and an easier revision operation with the conventional total hip arthroplasty. Most of these advantages of hip resurfacing are theoretical and evidence from clinical trials is still lacking.

Conclusion: Outcome after large-diameter THA and hip resurfacing (HRA) was similar in this prospective randomized control trial. It is unclear if HRA has any benefits over conventional cementless large-diameter THA.

Step activity levels after surface replacement and total hip arthroplasty in a young, active population. 
Author: Nunley et al.

There has been recent interest in surface-replacement arthroplasties (SRA) as an alternative to total hip arthroplasty (THA) although there is limited objective data to support claims that SRA allows patients to be more active postoperatively.

Conclusion: Step activity monitoring data indicates that both SRA and THA patients increase activity levels following surgery, but we found no objective evidence to support the claim that SRA patients are more active than THA patients.

2012 American Academy of Orthopedic Surgeons (AAOS) Meeting – San Francisco; selected excerpts.

-JGM