Hip-Resurfacing Arthroplasty an Alternative to Total Hip Replacement

In comparison, THA requires resection of the femoral neck, making the hip more susceptible to dislocation postoperatively. However, HR is a more technically demanding surgical procedure than THA and typically requires a larger incision than THA.⁶

Current research indicates that patients post-HR benefit from a more dynamic tailored rehabilitation program compared with a traditional THA approach.^2,8 It’s important for physical therapists working with this patient population to be familiar with outcomes and prognosis following this procedure, as well as complications, such as femoral neck fractures.² Femoral neck fractures typically occur early in the postoperative rehabilitation and are more common in women.⁹ An incidence of 1.46% has been reported.⁹

Rates of groin pain post­operatively have been reported to be as high as 18%, and causes include hip impingement, component malpositioning, iliopsoas tendinopathy and adverse soft-tissue reactions.10 Facilitation of good recruitment of lumbopelvic muscles and avoiding overuse of the psoas major muscle postoperatively are important to help prevent iliopsoas pathology.² Adverse soft tissue reactions may be due to sensitivity to wear particles from MoM chromium and cobalt implant components.¹⁰

Other postoperative complications include prosthetic loosening and heterotrophic ossification.⁹

Current research indicates that returning to running is possible after HR; however, long-term follow-up is required to assess the impact of running and other high-impact activities on the prosthetic components, loosening and revision rates.¹¹ Patients who have undergone HR have a high rate of return to sport and have been able to return to recreational sports without restrictions.^5,12

In comparison, return to high-impact sport after THA has been associated with increased wear and mechanical failure of the implant.¹³ Patients with THA are more likely to discontinue high-impact activities and shift to low-impact activities, such as exercise walking.¹⁴

Following HR, patients have reported improved quality of life and a high rate of satisfaction with their outcome.¹⁵ The medium-term outcomes, up to 13 years postoperatively, for patients following HR with a BHR are very favorable.¹

Research Needed

Further research is needed to investigate the long-term outcomes of high-functioning patients following HR and to investigate any potential long-term risk of adverse metal hypersensitivity reactions associated with MoM articulations.

Caitlyn M. Beltrani, PT, DPT, received a clinical doctorate in Physical Therapy from Northeastern University in 2014. Caitlyn is passionate about orthopedic sports medicine and rehabilitating athletes of all ages.