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Mike S. McGrath, MD1,
Dana R. Desser, DO2, Slif D. Ulrich,
MD1, Thorsten M. Seyler, MD3,
David R. Marker, BS1 and
Michael A. Mont, MD1
1 Rubin Institute for Advanced
Orthopedics, Sinai Hospital of Baltimore, 2401 West
Belvedere Avenue, Baltimore, MD 21215. E-mail address for
M.A. Mont:
2 Department of Orthopaedic Surgery, York
Memorial Hospital, 325 South Belmont Street, York, PA 17405
3 Department of Orthopaedic Surgery, Wake Forest
University School of Medicine, Medical Center Boulevard,
Winston-Salem, NC 27103
Background: Metal-on-metal total hip resurfacing arthroplasty
has been associated with excellent early results in
patients who are younger than sixty years of age,
but it remains controversial whether this
procedure is appropriate in older patients. The
purpose of the present study was to compare the clinical and
radiographic outcomes after hip resurfacing in two
cohorts of patients: those who were sixty years
of age or older, and those who were younger than
sixty years of age.
Methods: Between November 2002 and August 2005,
thirty-five patients (forty hips) who were sixty
years of age or older were managed with
metal-on-metal total hip resurfacing arthroplasty.
The outcomes of these patients were compared with
those of 130 patients (153 hips) who were younger
than sixty years of age but otherwise had similar
preoperative parameters and who had resurfacing
arthroplasty performed during the same time interval
and by the same surgeon. We evaluated Harris hip
scores, Short Form-12 scores, and complications
as well as radiographic alignment and
radiolucencies.
Results: At a mean follow-up time of thirty-six
months, the mean Harris hip scores improved from
52 points to 94 points in the older patient
cohort and from 53 points to 92 points in the
younger patient cohort. The final Short Form-12 scores
of the two groups were also similar. Two patients who
were sixty years or older and five of the younger
patients required conversion to a conventional
total hip arthroplasty. Femoral neck fracture was
the reason for one conversion in each group. There were
no impending radiographic failures in either cohort.
Conclusions: Although national registries indicate
that the risk of femoral neck fracture is higher
in older patients, the present study found that
these patients had excellent clinical outcomes
that were similar to those of patients who were younger.
We await longer follow-up results to determine further
outcomes in these patients
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