The Journal of Bone and Joint Surgery, Vol 68, Issue 2 216-225, Copyright © 1986 by Journal of Bone and Joint Surgery, Inc
Conventional versus resurfacing total hip arthroplasty. A long-term prospective study of concomitant bilateral implantation of prostheses
MA Ritter and TJ Gioe
Fifty patients requiring bilateral total hip arthroplasty underwent a
concomitant conventional hip arthroplasty on one side and an articular
resurfacing procedure on the other, done by the senior one of us (M. A.
R.). The average age of the patients was sixty-two years (range, twenty-one
to eighty-seven years), and forty-seven of them were followed with serial
radiographs and clinical evaluation for one year or more. The length of
follow-up was five years for thirty-four patients with both prostheses
intact. The average pain score for all hips at three years postoperatively
was 5.5 points. Although the majority of patients at each follow-up
interval did not prefer one procedure to the other, the conventional
arthroplasty was significantly superior for those who had a preference, and
radiographic evaluation revealed a statistically significant increased
incidence of acetabular lucency at the bone-cement interface of the
resurfacing arthroplasty at one, two, three, five, and seven years
postoperatively (p less than 0.002). Two of the conventional prostheses
were revised during this time-period (one because of infection and one, a
broken stem) whereas thirteen (26 per cent) of the resurfacing prostheses
were revised (eight hips had femoral loosening, five with concomitant
acetabular loosening; three had acetabular loosening; and one had a femoral
neck fracture) at an average of fifty-two months postoperatively (p less
than 0.001).
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