Total Hip Arthroplasty versus Hip Resurfacing: Evidence Based Review and Current Indications

Total hip arthroplasty (THA) is the gold standard in the treatment of degenerative hip disease, especially in the older patient. Concerns regarding the higher levels of failure of traditional implants in younger, more active patients have led to a search for alternative arthroplasty techniques. Hip resurfacing (HR) is one of these alternatives. When compared with THA, HR has some theoretical advantages that stem from preservation of the patient’s normal proximal femoral anatomy and the use of a large diameter metal on metal bearing. This has the potential to more accurately replicate physiological hip function, reduce the risk of dislocation and allow higher levels of activity with minimal wear of the articulating surface. In addition, the preservation of proximal femoral bone stock offers the potential for easier revision options as would inevitably be required in younger patients. In order to be considered a suitable alternative, HR would need to demonstrate improvements or at least equivalence in functional outcomes and survivorship along with evidence of successful preservation of bone stock leading to good outcomes from future revision surgery. Whilst the recent expansion of data both in the orthopaedic literature and the mainstream media concerning the potentially devastating problems from large metal-on-metal (MoM) bearings in some settings carries some salient lessons for both the development, marketing and uptake of new orthopaedic implants, it should be put in the context of the resurfacing literature as a whole. In this review we aim to review the current evidence base for HR compared with THA and examine the current indications for the procedure. *Corresponding author: Pascal-Andre Vendittoli, Professor of surgery, Montreal University, Maisonneuve Rosemont Hospital, 5415 boulevard de l’Assomption, Montreal, Quebec H1T 2M4, Canada, Tel: 514 252-3823, Fax: 514 252-0115; E-mail: [email protected] Received July 30, 2014; Accepted October 31, 2014; Published November 04, 2014 Citation: Hutt JRB, Lavigne M, Vendittoli PA (2014) Total Hip Arthroplasty versus Hip Resurfacing: Evidence Based Review and Current Indications. Orthop Muscul Syst 3: 173. doi:10.4172/2161-0533.1000173 Copyright: © 2014 Hutt JRB, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.