Revision of failed hip resurfacing arthroplasty to total hip arthroplasty-a case series and review of literature

Background: Revision rate of hip resurfacing in most national registries nearly 3.5%. Conversion to total hip replacement may be the correct option for those whose activity levels changed and the need for hip resurfacing no longer required.

Purpose: Assessing outcomes of failed hip resurfacing to total hip arthroplasty. Primary outcomes included improvement of Oxford, WOMAC, Harris, and UCLA hip scores. Secondary outcomes included surgical site infection, residual groin pain, and heterotopic ossification.

Study design: Prospective case series.

Level of evidence: Level IV.

Patients and Methods: 25 patients underwent revision hip resurfacing to total hip arthroplasty. Mean age 56.8 years. Indications for revision: femoral neck fractures (10 cases), femoral neck thinning (3 cases), component loosening (4 cases) component dislocation (2 cases) persistent groin pain, and clicking (3 cases) and component wear (3 cases). Nineteen patients revised both components and six revised femoral components only.

Results: Average duration of follow up 26.8 months (28-48 months) and the procedure was successful in 23 (92%) patients. Preoperative Oxford, WOMAC, Harris, and UCLA hip scores were 21.3, 78.3, 35,7, and 2 respectively improved to 39.8, 11.1, 92.3, and 7 respectively at last follow-up representing statistically significant improvements (p<0.0001) for each score 3 cases (12%) with complications; surgical site infection (1 case), residual groin pain (1 case), and mild heterotopic ossification (1 case).

Conclusion: Conversion of hip resurfacing to THA has high satisfaction rates. These results compare favorably with those for revision total hip arthroplasty.

Keywords

hip resurfacing arthroplasty, total hip arthroplasty, femoral neck fractures, component loosening