Our Summary

This study compared three different types of hip replacement surgeries: hip resurfacing arthroplasty (HRA), total hip arthroplasty (THA) using a metal-on-polyethylene (MoP) component, and a new technique called Mitch proximal epiphyseal replacement (PER). They looked at how often these surgeries needed to be redone (or revised) over a certain period of time.

They found that 11% of the HRAs needed to be revised after 10 years, compared to only 6.4% of the MoP THAs. However, when they excluded a specific type of component (the ASR) from the HRAs, the revision rate dropped to close to that of the MoP THAs.

For the new Mitch PER technique, the revision rate after 8 years was 9.6%, compared to 5.4% for the MoP THAs. However, this difference was not statistically significant, meaning it could have happened by chance.

In simple terms, the study found that the traditional MoP THA had the lowest chance of needing to be redone, followed by the HRA (if the ASR component was excluded) and the new Mitch PER technique. However, more research is needed to confirm these findings.

FAQs

  1. What were the three types of hip replacement surgeries compared in the study?
  2. How did the revision rates of the three types of hip replacement surgeries compare?
  3. What was the impact of excluding the ASR component from the HRA on the revision rate?

Doctor’s Tip

A doctor might tell a patient undergoing hip replacement surgery to choose a metal-on-polyethylene (MoP) total hip arthroplasty (THA) for the lowest risk of needing a revision surgery in the future. It’s important to discuss all options with your doctor and weigh the pros and cons of each type of surgery before making a decision. Additionally, following post-operative rehabilitation and physical therapy recommendations can help improve outcomes and reduce the risk of complications after hip replacement surgery.

Suitable For

Patients who are typically recommended for hip replacement surgery include those with severe hip pain and stiffness that limits daily activities, arthritis in the hip joint, hip fractures, avascular necrosis, or other conditions that cause damage to the hip joint. The decision to undergo hip replacement surgery is typically made in consultation with an orthopedic surgeon after conservative treatments such as medication, physical therapy, and lifestyle modifications have not provided sufficient relief.

Timeline

Before hip replacement surgery, a patient typically experiences chronic hip pain, stiffness, and limited range of motion. They may have difficulty walking, standing, or performing daily activities. They may have tried other conservative treatments such as physical therapy, medications, or cortisone injections without success.

After hip replacement surgery, the patient will go through a period of recovery and rehabilitation. This includes staying in the hospital for a few days, followed by physical therapy and exercises to strengthen the hip muscles and improve range of motion. The patient may need to use a walker or cane initially and gradually transition to walking without assistance. Over time, the hip pain should decrease, and the patient should be able to return to normal activities with improved mobility and function.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with each type of hip replacement surgery?
  2. How long can I expect the hip replacement to last before needing to be revised?
  3. What factors should I consider when choosing between hip resurfacing arthroplasty, total hip arthroplasty with a metal-on-polyethylene component, or the Mitch proximal epiphyseal replacement technique?
  4. Are there any specific lifestyle changes or precautions I should take after undergoing hip replacement surgery?
  5. What is the recovery process like for each type of hip replacement surgery?
  6. How experienced are you in performing the specific type of hip replacement surgery I am considering?
  7. Are there any alternative treatment options to hip replacement that I should explore before making a decision?
  8. Can you provide me with information on the success rates of each type of hip replacement surgery at your practice?
  9. Will I need physical therapy or rehabilitation after the surgery, and if so, for how long?
  10. How often will I need follow-up appointments after the surgery to monitor my progress and address any concerns?

Reference

Authors: Tang-Jensen M, Kjærsgaard-Andersen P, Poulsen TK, Overgaard S, Varnum C. Journal: Acta Orthop. 2019 Dec;90(6):523-529. doi: 10.1080/17453674.2019.1646201. Epub 2019 Jul 25. PMID: 31340710