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A DISTRICT GENERAL HOSPITAL’S EXPERIENCE OF HIP RESURFACING.



Abstract

Introduction Hip resurfacing is a method of treating the degenerative hip joint in higher demand patients. In this study we present the results of the first four years of using this technique in a typical District General Hospital.

Materials and Methods This is a review of the outcome of 303 consecutive hip resurfacing procedures performed at Ashford and St. Peter’s Hospitals NHS Trust. All the operations were carried out through a posterior approach to the hip joint, followed by standard resurfacing using metal on metal components. The patients were evaluated radiographically and clinically pre-operatively and post-operatively. All patients had regular follow up.

Results The mean age was 56 years old with a range from 24 to 75 years. There was a statistically significant improvement between the pre-operative Harris Hip Score and the score at the latest follow up. All patients achieved a full range movement in the hip within twelve weeks following surgery. There were four fractures of the femoral neck, one was intra-operative and was converted to a traditional total joint arthroplasty. Three fractures occurred later, two were revised to a hybrid standard hip arthroplasty with a cemented stem and uncemented cup and one was treated conservatively. Two patients had transient femoral nerve palsies. There were no cases of dislocation or deep infection. All the prostheses remain well fixed with no signs of osteolysis.

Three procedures were performed because of avascular necrosis of the femoral head; none of these show signs of further collapse.

Conclusions The short and medium term results that have been achieved in a District General Hospital are comparable to those that have been achieved in the originator’s institution.

Editoral Secretary Mr Peter Howard. Correspondence should be addressed to BHS at the Royal College of Surgeons, 35 - 43 Lincoln’s Inn Fields, London WC2A 3PN.