No Clinically Meaningful Differences in 1-Year Patient-Reported Outcome Measures between Hip Resurfacing and Total Hip Arthroplasty: An Age-Matched Prospective Cohort Study

Abstract

This study compared patient-reported outcome measures (PROMs), readmissions, and reoperations between hip resurfacing (HR) and total hip arthroplasty (THA) in a matched prospective cohort. Between 2015 and 2017, 4,268 patients underwent HR or THA at a single institution. A prospective cohort of 2,147 patients were enrolled (707 HRs, 1,440 THAs). PROMs were collected at baseline and 1-year follow-up. Exclusion criteria: females (n = 2,008), inability/refusal to complete PROMs (n = 54), and diagnosis other than osteoarthritis (n = 59). Each HR patient was age-matched to a THA patient. Multivariate regression models were constructed to control for race, body mass index, education, smoking status, Charlson Comorbidity Index, mental health, and functional scores. A significance threshold was set at p = 0.017. A total of 707 HRs and 707 THAs were analyzed and 579 HRs (81.9%) and 490 THAs (69.3%) were followed up at 1 year. There was no statistically significant difference for Hip Injury and Osteoarthritis Outcomes Score (HOOS) Pain subscale (p = 0.129) and HOOS-Physical Function Shortform (HOOS-PS) (p = 0.03). HR had significantly higher median University of California in Los Angeles (UCLA) activity scores (p = 0.004). Ninety-day readmissions for HR and THAs were 1.8 and 3.5%, respectively (p = 0.06), and reoperations at 1 year were 1.2 and 2.3%, respectively (p = 0.24). For male patients, differences in medians for UCLA activity scores were 0.383 points, which were statistically significant but may not be clinically relevant. No differences exist in 90-day readmissions, reoperations, and HOOS^pain and HOOS-PS scores. Because patients undergoing HR are advised to return to full activity at 1-year postoperative, follow-up is required. Metal ion levels were not obtained postoperatively for either group.

Keywords

total hip arthroplasty - hip resurfacing - patient-reported outcome measures - PROMs - age-matched

Collaborators

Nicolas S. Piuzzi, Wael K. Barsoum, Michael R. Bloomfield, Peter J. Brooks, Robert J. Hampton, Carlos A. Higuera, Alison K. Klika, Viktor E. Krebs, John P. McLaughlin, Nathan W. Mesko, Robert M. Molloy, Michael A. Mont, George F. Muschler, Trevor G. Murray, Robert J. Nickodem, Lukas M. Nystrom, Preetesh D. Patel, Brendan M. Patterson, Kim L. Stearns, Gregory J. Strnad, Kurt P. Spindler, Atul F. Kamath (Cleveland Clinic Department of Orthopaedic Surgery, Cleveland, Ohio); Juan C. Suarez (Cleveland Clinic Department of Orthopaedic Surgery, Weston, Florida); Alexander Zajicheck (Cleveland Clinic Department of Quantitative Health Sciences, Cleveland, Ohio).

Publikationsverlauf

Eingereicht: 03. März 2020

Angenommen: 30. Juni 2020

Artikel online veröffentlicht:
15. Juni 2021

• References

• 1 dela Rosa MA, Silva M, Heisel C, Reich M, Schmalzried TP. Range of motion after total hip resurfacing. Orthopedics 2007; 30 (05) 352-357
• 2 Zywiel MG, Marker DR, McGrath MS, Delanois RE, Mont MA. Resurfacing matched to standard total hip arthroplasty by preoperative activity levels - a comparison of postoperative outcomes. Bull NYU Hosp Jt Dis 2009; 67 (02) 116-119
• 3 Smolders JMH, Hol A, Rijnders T, van Susante JLC. Changes in bone mineral density in the proximal femur after hip resurfacing and uncemented total hip replacement: a prospective randomised controlled study. J Bone Joint Surg Br 2010; 92 (11) 1509-1514
• 4 Brown NM, Foran JRH, Della Valle CJ. Hip resurfacing and conventional THA: comparison of acetabular bone stock removal, leg length, and offset. Orthopedics 2013; 36 (05) e637-e641
• 5 Brooks PJ, Samuel LT, Levin JM. et al. Mortality after hip resurfacing versus total hip arthroplasty in young patients: a single surgeon experience. Ann Transl Med 2019; 7 (04) 77
• 6 Lons A, Arnould A, Pommepuy T, Drumez E, Girard J. Excellent short-term results of hip resurfacing in a selected population of young patients. Orthop Traumatol Surg Res 2015; 101 (06) 661-665
• 7 Lingard EA, Muthumayandi K, Holland JP. Comparison of patient-reported outcomes between hip resurfacing and total hip replacement. J Bone Joint Surg Br 2009; 91 (12) 1550-1554
• 8 Kendal AR, Prieto-Alhambra D, Arden NK, Carr A, Judge A. Mortality rates at 10 years after metal-on-metal hip resurfacing compared with total hip replacement in England: retrospective cohort analysis of hospital episode statistics. BMJ 2013; 347: f6549
• 9 McMinn DJW, Daniel J, Ziaee H, Pradhan C. Indications and results of hip resurfacing. Int Orthop 2011; 35 (02) 231-237
• 10 Nunley RM, Zhu J, Brooks PJ. et al. The learning curve for adopting hip resurfacing among hip specialists. Clin Orthop Relat Res 2010; 468 (02) 382-391
• 11 Dunbar MJ, Prasad V, Weerts B, Richardson G. Metal-on-metal hip surface replacement: the routine use is not justified. Bone Joint J 2014; 96-B (11, Supple A): 17-21
• 12 Nunley RM, Della Valle CJ, Barrack RL. Is patient selection important for hip resurfacing?. Clin Orthop Relat Res 2009; 467 (01) 56-65
• 13 Ford MC, Hellman MD, Kazarian GS, Clohisy JC, Nunley RM, Barrack RL. Five to ten-year results of the Birmingham Hip Resurfacing Implant in the U.S.: a single institution's experience. J Bone Joint Surg Am 2018; 100 (21) 1879-1887
• 14 Issa K, Palich A, Tatevossian T, Kapadia BH, Naziri Q, Mont MA. The outcomes of hip resurfacing compared to standard primary total hip arthroplasty in Men. BMC Musculoskelet Disord 2013; 14: 161
• 15 Sandiford NA, Muirhead-Allwood SK, Skinner JA, Hua J. Metal on metal hip resurfacing versus uncemented custom total hip replacement--early results. J Orthop Surg Res 2010; 5: 8
• 16 Costa ML, Achten J, Foguet P, Parsons NR. Young Adult Hip Arthroplasty team. Comparison of hip function and quality of life of total hip arthroplasty and resurfacing arthroplasty in the treatment of young patients with arthritis of the hip joint at 5 years. BMJ Open 2018; 8 (03) e018849
• 17 Mont MA, Marker DR, Smith JM, Ulrich SD, McGrath MS. Resurfacing is comparable to total hip arthroplasty at short-term follow-up. Clin Orthop Relat Res 2009; 467 (01) 66-71
• 18 Fowble VA, dela Rosa MA, Schmalzried TP. A comparison of total hip resurfacing and total hip arthroplasty - patients and outcomes. Bull NYU Hosp Jt Dis 2009; 67 (02) 108-112
• 19 Haddad FS, Konan S, Tahmassebi J. A prospective comparative study of cementless total hip arthroplasty and hip resurfacing in patients under the age of 55 years: a ten-year follow-up. Bone Joint J 2015; 97-B [phone]
• 20 Oxblom A, Hedlund H, Nemes S, Brismar H, Felländer-Tsai L, Rolfson O. Patient-reported outcomes in hip resurfacing versus conventional total hip arthroplasty: a register-based matched cohort study of 726 patients. Acta Orthop 2019; 90 (04) 318-323
• 21 Halawi MJ, Oak SR, Brigati D, Siggers A, Messner W, Brooks PJ. Birmingham hip resurfacing versus cementless total hip arthroplasty in patients 55 years or younger: a minimum five-year follow-up. J Clin Orthop Trauma 2018; 9 (04) 285-288
• 22 Ortiz-Declet VR, Iacobelli DA, Yuen LC, Perets I, Chen AW, Domb BG. Birmingham hip resurfacing vs total hip arthroplasty: a matched-pair comparison of clinical outcomes. J Arthroplasty 2017; 32 (12) 3647-3651
• 23 Stulberg BN, Trier KK, Naughton M, Zadzilka JD. Results and lessons learned from a United States hip resurfacing investigational device exemption trial. J Bone Joint Surg Am 2008; 90 (Suppl. 03) 21-26
• 24 Pollard TCB, Baker RP, Eastaugh-Waring SJ, Bannister GC. Treatment of the young active patient with osteoarthritis of the hip. A five- to seven-year comparison of hybrid total hip arthroplasty and metal-on-metal resurfacing. J Bone Joint Surg Br 2006; 88 (05) 592-600
• 25 Corten K, MacDonald SJ. Hip resurfacing data from national joint registries: what do they tell us? What do they not tell us?. Clin Orthop Relat Res 2010; 468 (02) 351-357
• 26 Smith TO, Nichols R, Donell ST, Hing CB. The clinical and radiological outcomes of hip resurfacing versus total hip arthroplasty: a meta-analysis and systematic review. Acta Orthop 2010; 81 (06) 684-695
• 27 Vail TP, Mina CA, Yergler JD, Pietrobon R. Metal-on-metal hip resurfacing compares favorably with THA at 2 years followup. Clin Orthop Relat Res 2006; 453 (453) 123-131
• 28 Garbuz DS, Tanzer M, Greidanus NV, Masri BA, Duncan CP. The John Charnley Award: Metal-on-metal hip resurfacing versus large-diameter head metal-on-metal total hip arthroplasty: a randomized clinical trial. Clin Orthop Relat Res 2010; 468 (02) 318-325
• 29 Vendittoli PA, Ganapathi M, Roy AG, Lusignan D, Lavigne M. A comparison of clinical results of hip resurfacing arthroplasty and 28 mm metal on metal total hip arthroplasty: a randomised trial with 3-6 years follow-up. Hip Int 2010; 20 (01) 1-13
• 30 Cleveland O, Piuzzi NS, Strnad G. et al; OME Cleveland Clinic Orthopaedics. Implementing a scientifically valid, cost-effective, and scalable data collection system at point of care: the Cleveland Clinic OME Cohort. J Bone Joint Surg Am 2019; 101 (05) 458-464
• 31 Piuzzi NS, Strnad GJ, Sakr Esa WA. et al; Cleveland Clinic Orthopaedic Arthroplasty Group. The main predictors of length of stay after total knee arthroplasty: patient-related or procedure-related risk factors. J Bone Joint Surg Am 2019; 101 (12) 1093-1101
• 32 Urgent Medical Device Market Removal - BIRMINGHAM HIP™ RESURFACING (BHR) SYSTEM. Published date: June 3, 2015. Accessed July 28, 2019 at: http://www.smith-nephew.com/global/assets/pdf/products/surgical/bhr_urgent_medical_device_market_removal.pdf
• 33 Total hip replacement and resurfacing arthroplasty for end-stage arthritis of the hip - Evidence and Interpretation. Published date: February 26, 2014. Accessed July 28, 2019 at: https://www.nice.org.uk/guidance/ta304/chapter/4-Evidence-and-interpretation
• 34 Nilsdotter A, Bremander A. Measures of hip function and symptoms: Harris Hip Score (HHS), Hip Disability and Osteoarthritis Outcome Score (HOOS), Oxford Hip Score (OHS), Lequesne Index of Severity for Osteoarthritis of the Hip (LISOH), and American Academy of Orthopedic Surgeons (AAOS) Hip and Knee Questionnaire. Arthritis Care Res (Hoboken) 2011; 63 (Suppl. 11) S200-S207
• 35 Centers for Medicare & Medicaid Services. Measure Methodology. Accessed May 20, 2019 at: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/Measure-Methodology.html
• 36 Davis AM, Perruccio AV, Canizares M. et al. Comparative, validity and responsiveness of the HOOS-PS and KOOS-PS to the WOMAC physical function subscale in total joint replacement for osteoarthritis. Osteoarthritis Cartilage 2009; 17 (07) 843-847
• 37 Terwee CB, Bouwmeester W, van Elsland SL, de Vet HCW, Dekker J. Instruments to assess physical activity in patients with osteoarthritis of the hip or knee: a systematic review of measurement properties. Osteoarthritis Cartilage 2011; 19 (06) 620-633
• 38 Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987; 40 (05) 373-383
• 39 Prokopetz JJ, Losina E, Bliss RL, Wright J, Baron JA, Katz JN. Risk factors for revision of primary total hip arthroplasty: a systematic review. BMC Musculoskelet Disord 2012; 13: 251
• 40 SooHoo NF, Li Z, Chenok KE, Bozic KJ. Responsiveness of patient reported outcome measures in total joint arthroplasty patients. J Arthroplasty 2015; 30 (02) 176-191
• 41 Imam MA, Barke S, Stafford GH, Parkin D, Field RE. Loss to follow-up after total hip replacement: a source of bias in patient reported outcome measures and registry datasets?. Hip Int 2014; 24 (05) 465-472
• 42 Steffen R, O'Rourke K, Gill HS, Murray DW. The anterolateral approach leads to less disruption of the femoral head-neck blood supply than the posterior approach during hip resurfacing. J Bone Joint Surg Br 2007; 89 (10) 1293-1298
• 43 Khan A, Yates P, Lovering A, Bannister GC, Spencer RF. The effect of surgical approach on blood flow to the femoral head during resurfacing. J Bone Joint Surg Br 2007; 89 (01) 21-25
• 44 Mjaaland KE, Kivle K, Svenningsen S, Nordsletten L. Do postoperative results differ in a randomized trial between a direct anterior and a direct lateral approach in THA?. Clin Orthop Relat Res 2019; 477 (01) 145-155
• 45 Graves SC, Dropkin BM, Keeney BJ, Lurie JD, Tomek IM. Does surgical approach affect patient-reported function after primary THA?. Clin Orthop Relat Res 2016; 474 (04) 971-981