10 Year Follow-Up of a Prospective Randomised Study of Cementless Total Hip Replacement Versus Hip Resurfacing in Young Adults Under the Age of 55.

Introduction The purpose of this study was to evaluate the functional outcome in the medium and long-term of hip resurfacing in comparison with cementless hip replacement in patients under the age of 55. Methods Eighty patients were enrolled between 1999 and 2002. Twenty-four were randomised (11 hip re-surfacing, 13 total hip replacement), 18 refused hip resurfacing and chose cementless total hip replacement with a 32 mm bearing, 38 insisted on re-surfacing. All the patients have been reviewed at a minimum follow-up of 8 years and a mean of 10.1 years. Patients were assessed clinically and radiographically at one year, five years, eight years and ten years. Outcome measures included EQ 5, SF 36, Oxford, Harris hip, UCLA and UCH scores. Results No difference was seen in the Oxford, Harris hip score or in the quality of life scores between the two groups. The UCH functional hip score, however, showed significantly higher function scores in hip resurfacing patients compared with hip replacement patients; this was maintained at one year, five years and eight to ten years. All the patients showed a decline in high level activities and UCLA score over the period of the study. In spite of a similar aspiration to activity pre-operatively, a higher proportion of hip resurfacing patients were running and involved in sport and heavy manual work after five years. In this cohort there have been no failures in metal to metal articulation and there has only been one dislocation in the total hip group. Discussion Activity measures in this small cohort suggest an advantage in hip resurfacing over hip replacement. In this patient group we have not seen the dramatic problems reported elsewhere with hip resurfacing.