Adoption of Hip Resurfacing Arthroplasty at Hospital for
Special Surgery: a Cohort Study

Edwin P. Su and Sherwin L. Su June 4, 2010

Background
Hip resurfacing arthroplasty (HRA) is an alternative to
traditional total hip replacement (THR) that allows for the
preservation of femoral bone. It is a more technically
difficult procedure that has led some researchers to report
an unsatisfactory learning curve (Berend et al., J Bone
Joint Surg Am Suppl 2:89–92, 2011; Mont et al., Clin Orthop
Relat Res 465:63–70, 2007).

Purpose
The purpose of this study was to investigate the adoption of
HRA at our institution, examining the clinical results,
revision rate, and modes of failure. Additionally, a
comparison of three different implant systems was performed.

Methods
A retrospective review of a consecutive series of HRA
performed at our institution between the years 2004 and 2009
was carried out. A total of 820 HRA with a minimum of 2
years of follow-up were included in the study. The majority
of included patients were males (70%), with osteoarthritis
(92%). The average age was 49.8 years, and the mean BMI was
27.5 kg/m2.

Results
The average Harris hip score improved from 61 to 96.5
postoperatively. Thirteen revisions (1.6%) were performed
for femoral neck fracture, femoral head osteonecrosis,
acetabular loosening, metal reactivity/metallosis, and metal
allergy. The overall Kaplan–Meier survival curve with
revision surgery as an endpoint showed 98.5% survival at 5
years. There were no observable differences in clinical
scores or revision rates between the different implant
systems.

Conclusions
HRA can be successfully adopted with a low complication
rate, given careful patient selection, specialized surgical
training, and use of good implant design.