Clinical Comparative Study Of The Efficacy Of Hip Resurfacing And Total Hip Replacement

Objective The purpose of this study was to evaluate the clinical outcomes of hip resurfacing patients and compare them to standard primary total hip arthroplasty procedures performed during the same period of time.Methods Twenty nine cases(37hips)treated with RSAH were analyzed retrospectively from may2006to June2011. There were17males and12females, with a mean age of47.8years(range,18-64years),21cases of unilateral and8cases of bilateral. Twelve cases(12hips)were diagnosed as developmental dysplasia of the hip,5cases(6hips)as osteonecrosis of the femoral head,5cases(7hips)as ankylosing spondylitis,3cases(4hips)as rheumatoid arthritis,1case(lhip)as osteoarthritis,2case(2hip)as pigmented villonodular synovitis,1case(1hip)as hip retraction syndrome. Thirty two cases(39hips)treated with THR were analyzed retrospectively from October2007to August2011. There were15males and17females, with a mean age of56.1years(range,25-88years),25cases of unilateral and7cases of bilateral. Fifteen cases(18hips)were diagnosed as developmental dysplasia of the hip,13cases(15hips)as osteonecrosis of the femoral head,4case(6hip)as osteoarthritis.All cases were checked by MR or CT scan for observing the structure of the acetabulum and femoral head, osteolysis, osteosclerosis as well as the location of necrosis. The X-ray film Was performed before operation and after operation(1month,3months and every6months)to check the prosthesis loosening, migration and heterotopic ossification. The time of operation, blood loss during operation, incision length, hospitalization postoperative was record and Harris hip score, WOMAC pain score system, range of motion was used to evaluate the clinical results. The results were statistically analyzed.Results Statistical analysis shows, the operation time of RSAH hasn’t significant difference in statistically with THR (t=0.985, P>0.05), blood loss during operation is less than THR (t=4.794,P<0.05), incision length is longer than THR (t=11.388,P<0.05), hospitalization postoperative is shorter than THR (t=4.077,P<0.05); Both of the two postoperative Harris hip scores were significantly higher than before the surgery (t=14.905, P<0.01and t=35.208, P＜0.01),Both of the two postoperative Harris hip score has no significant difference (t=1.552, P>0.05); The preoperative and postoperative WOMAC pain score difference of the two surgery has no significant difference in statistically (t=1.475, P>0.05); RSAH has greater range of hip flexion than THR (t=4.862, P<0.01). Both groups before and after surgery AMA/BMA ratio and AMA/BMA ratio of the two after surgery were not statistically different (P>0.05).Conclusion: The RSAH has a satisfactory short-term effect on the conditions of Strict surgical indications and precise surgical techniques.