Hip Service, Department of Orthopaedics, Schulthess Clinic, Zürich, Switzerland.
Eur Cell Mater. 2011 Mar 15;21:243-58. doi: 10.22203/ecm.v021a19.
Hip resurfacing arthroplasty (HRA) is a concept of hip replacement that allows treating young active patients with a femoral bone preserving procedure. The proposed advantages of resuming an active lifestyle with increased frequency and duration of sports activities have been shown to be realistic. The 30-year cost-effectiveness in young male patients has been shown to be higher in resurfacing compared to conventional total hip replacement (THA). However, prognosticators of an inferior outcome have also been identified. The most important patient related factors are secondary osteoarthritis as the indication for surgery such as post-childhood hip disorders or AVN, female gender, smaller component sizes and older age (>65 years for males and >55 years for females). In addition, surgical technique (approach and cementing technique) and component design are also important determinant factors for the risk of failure. Moreover, concerns have surfaced with respect to high metal ion concentrations and metal ion hypersensitivities. In addition, the presumed ease of revising HRA has not reflected in improved or equal survivorship in comparison to a primary THA. This highlights the importance of identifying patient-, surgery-, and implant-related prognosticators for success or failure of HRA. Rather than vilifying the concept of hip resurfacing, detailed in depth analysis should be used to specify indications and improve implant design and surgical techniques.
髋关节表面置换术（HRA）是一种髋关节置换的理念，它允许通过保留股骨的手术来治疗年轻活跃的患者。已经证明，恢复积极的生活方式并增加运动活动的频率和持续时间具有现实意义。与传统的全髋关节置换术（THA）相比，年轻男性患者的 30 年成本效益在表面置换中更高。然而，也已经确定了预后较差的预测因素。最重要的患者相关因素是继发性骨关节炎作为手术指征，如儿童期后髋关节疾病或 AVN、女性、较小的组件尺寸和年龄较大（男性>65 岁，女性>55 岁）。此外，手术技术（入路和骨水泥技术）和组件设计也是失败风险的重要决定因素。此外，人们对高金属离子浓度和金属离子超敏反应表示担忧。此外，髋关节表面置换术假定易于翻修，但与初次 THA 相比，并未反映在改善或同等的存活率方面。这强调了确定髋关节表面置换术成功或失败的患者、手术和植入物相关预测因素的重要性。与其诋毁髋关节表面置换术的概念，不如详细深入地分析，以明确适应证并改进植入物设计和手术技术。
