Surface replacement hip arthroplasty: results of the first seventy-four consecutive cases at the University of California, San Francisco.

Although surface replacement hip arthroplasty has been viewed by some as a conservative alternative to conventional total hip arthroplasty, the surgical technique requires substantially more acetabular bone loss. To evaluate the efficacy of this operation, a retrospective study of 74 consecutive cases of surface replacement hip arthroplasty done at the University of California, San Francisco between February 1977 and June 1980 is reported and concludes that (1) there was no noteworthy difference in end result between cases using the Indiana, THARIES, or Freeman prostheses; (2) although there were major improvements in pain, function, and range of motion, unexplained pain persisted in 51.6% of cases; (3) the failure rate of 33.8% in the first 3 years was higher than that reported for conventional total hip arthroplasty; and (4) hips with a history of trauma failed the most frequently and showed the least improvement, whereas hips with osteoarthritis showed the fewest failures and the best results. We conclude that surface replacement hip arthroplasty is not superior to conventional total hip arthroplasty, judged by the criteria of pain relief, improvement of function, and failure rate.