Fowble Vincent A, dela Rosa Mylene A, Schmalzried Thomas P
Joint Replacement Institute, St. Vincent Medical Center, Los Angeles, California, USA.
Bull NYU Hosp Jt Dis. 2009;67(2):108-12.
A comparison of pertinent preoperative and postoperative data relative to total hip resurfacing versus total hip arthroplasty (THA) would assist in evaluating current perceptions in outcome. We compared 50 consecutive metal-metal resurfacing replacements in 50 patients with 44 consecutive conventional total hip arthroplasties in 35 patients, who were implanted during the same time period, by the same surgeon, and followed prospectively for 2 to 4 years. The patients undergoing hip resurfacing were 62% male, 9 years younger, and 3.2 inches taller, with a lower mean body mass index and American Society of Anesthesiologists (ASA) grade than patients undergoing total hip arthroplasty. Preoperatively, patients undergoing resurfacing had a lower Harris hip score (46 vs 52 points), more pain, higher UCLA (University of California at Los Angeles) activity scores (4.2 vs 3.6), and better range of motion. Surgical time for resurfacing was 18% longer, but there was less total blood loss and fewer transfusions. Postoperatively, there was no difference in Harris hip score (97 vs 96). Patients undergoing resurfacing had higher function, Short Form-12 physical activity scores, and UCLA activity scores, but also a higher incidence of slight or mild pain. There were no differences in postoperative range of motion or dislocation (one each). The preoperative characteristics and general health status of the average patient undergoing resurfacing are more favorable than that of the average patient undergoing conventional total hip arthroplasty. Caution should be applied in attributing differences in outcomes directly to the arthroplasty technology.
比较全髋关节表面置换术与全髋关节置换术（THA）相关的术前和术后数据，将有助于评估当前对手术结果的认知。我们将50例患者连续进行的50例金属对金属表面置换术与35例患者连续进行的44例传统全髋关节置换术进行了比较，这些手术由同一位外科医生在同一时期进行，并进行了2至4年的前瞻性随访。接受髋关节表面置换术的患者中男性占62%，比接受全髋关节置换术的患者年轻9岁，高3.2英寸，平均体重指数和美国麻醉医师协会（ASA）分级更低。术前，接受表面置换术的患者Harris髋关节评分较低（46分对52分），疼痛更多，加州大学洛杉矶分校（UCLA）活动评分较高（4.2对3.6），活动范围更好。表面置换术的手术时间长18%，但总失血量更少，输血次数也更少。术后，Harris髋关节评分无差异（97分对96分）。接受表面置换术的患者功能、简短健康调查问卷12项身体活动评分和UCLA活动评分更高，但轻微或轻度疼痛的发生率也更高。术后活动范围或脱位情况无差异（各有1例）。接受表面置换术的普通患者的术前特征和总体健康状况比接受传统全髋关节置换术的普通患者更有利。在将结果差异直接归因于关节置换技术时应谨慎。
