George Jose, Taylor Adam J, Schmalzried Thomas P
Department of Orthopedics, Harbor UCLA Medical Center, Torrance, CA 90509, United States.
World J Orthop. 2024 Jun 18;15(6):554-559. doi: 10.5312/wjo.v15.i6.554.
Hip resurfacing arthroplasty (HRA) is an alternative to total hip arthroplasty (THA) that is typically reserved for young active patients because it preserves bone. However, the benefits of HRA only hold true if conversion THA after failed HRA provides acceptable outcomes.
To compare patient reported outcomes for conversion THA after HRA failure to primary THA.
A retrospective review of 36 patients (37 hips) that underwent conversion THA for failed HRA between October 2006 and May 2019 by a single surgeon was performed. Patient reported outcomes [modified Harris Hip Score (mHHS), University of California Los Angeles (UCLA) activity score] were obtained an email-based responder-anonymous survey. Outcomes were compared to normative data of a primary THA cohort with similar demographics. Subgroup analysis was performed comparing outcomes of conversion THA for adverse local tissue reaction (ALTR) all other causes for failure.
The study group had a lower mHHS than the control group (81.7 ± 13.8 90.2 ± 11.6, < 0.01); however, both groups had similar UCLA activity levels (7.5 ± 2.3 7.2 ± 1.6, = 0.51). Patients that underwent conversion for non-ATLR causes had similar mHHS (85.2 ± 11.5 90.2 ± 11.6, = 0.11) and higher UCLA activity levels (8.5 ± 1.8 7.2 ± 1.6, < 0.01) compared to the control group. Patients that underwent conversion for ATLR had worse mHHS (77.1 ± 14.5 90.2 ± 11.6, < 0.01) and UCLA activity levels (6.1 ± 2.3 7.2 ± 1.6, = 0.05) when compared to the control group.
Patient outcomes equivalent to primary THA can be achieved following HRA conversion to THA. However, inferior outcomes were demonstrated for ALTR-related HRA failure. Patient selection and perhaps further studies examining alternative HRA bearing surfaces should be considered.
髋关节表面置换术（HRA）是全髋关节置换术（THA）的一种替代方法，通常适用于年轻的活跃患者，因为它能保留骨质。然而，只有当HRA失败后转换为THA能提供可接受的结果时，HRA的益处才成立。
比较HRA失败后转换为THA与初次THA患者报告的结果。
对2006年10月至2019年5月期间由一名外科医生为失败的HRA进行转换THA的36例患者（37髋）进行回顾性研究。通过基于电子邮件的无应答者匿名调查获得患者报告的结果[改良Harris髋关节评分（mHHS）、加利福尼亚大学洛杉矶分校（UCLA）活动评分]。将结果与具有相似人口统计学特征的初次THA队列的标准数据进行比较。进行亚组分析，比较因不良局部组织反应（ALTR）导致的转换THA与所有其他失败原因的结果。
研究组的mHHS低于对照组（81.7±13.8对90.2±11.6，P<0.01）；然而，两组的UCLA活动水平相似（7.5±2.3对7.2±1.6，P=0.51）。与对照组相比，因非ATLR原因进行转换的患者mHHS相似（85.2±11.5对90.2±11.6，P=0.11），UCLA活动水平更高（8.5±1.8对7.2±1.6，P<0.01）。与对照组相比，因ALTR进行转换的患者mHHS更差（77.1±14.5对90.2±11.6，P<0.01），UCLA活动水平更低（6.1±2.3对7.2±1.6，P=0.05）。
HRA转换为THA后可实现与初次THA相当的患者结果。然而，与ALTR相关的HRA失败显示出较差的结果。应考虑患者选择以及可能进一步研究检查替代的HRA承重表面。
