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Read Complete Study by clicking hereMay 2011Despite being proclaimed as “The operation of the century,” total hip
arthroplasty is far from an ideal procedure. In fact, one study found that “in
spite of a good hip score, only 43% of patients had all of their expectations
completely fulfilled,” said Robert L. Barrack, MD, chief of service, Orthopedic
Surgery, at Washington University School of Medicine in St. Louis, Mo.
Although patient selection is rarely an issue with total hip arthroplasty (THA)
and the surgical technique “is more forgiving,” selection and technique are
major issues with metal-metal hip resurfacing replacement arthroplasty (SRA),
according to Barrack, who spoke at the Current Concepts in Joint Replacement
2010 Winter Meeting. The indications for SRA are also “narrower, the implant is
more expensive, and the technique is more demanding and less forgiving.” To
justify the use of SRA rather than THA, Barrack noted, there should be some
objective clinical advantage.
Barrack was part of a recent multicenter study that evaluated the current level
of success and function of modern hip implants in returning high-demand patients
to crucial activities. A modern implant was defined as an uncemented tapered
titanium stem combined with an advanced bearing surface or a surface replacement
Data collection
All patients were younger than 60 years old with a high demand (a premorbid UCLA
score greater than 6). A novel method of collecting data was also employed.
“It was completely unbiased and blinded,” said Barrack, consisting of a phone
questionnaire to evaluate functional outcome among hip implants at a minimum of
1-year follow-up…
…The study began with a consecutive series of 1,400 patients, of whom more
than 60% completed the detailed survey, for a large sample size of more than 800
patients…
…In conclusion, SRA demonstrated objective evidence “of a higher level of
function and satisfaction compared to a similar THA cohort in limp, walking,
running, perceived limb length equality, and thigh pain,” said Barrack, who
advocates continued use and investigation of SRA in selected patients |
