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 HOOSpain 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
