Long-term Outcomes of Hip Resurfacing Arthroplasty: Higher Revision Rates in Female Patients with Dysplasia and Smaller Components After 14 Years

Overview

This study evaluates long-term outcomes of hip resurfacing arthroplasty (HRA) after a minimum follow-up of 14 years, highlighting higher revision rates in female patients with developmental dysplasia of the hip (DDH) and smaller component sizes. Dysplastic hips have poorer survivorship compared to hips with primary osteoarthritis or non-OA etiologies.

Background

Hip resurfacing arthroplasty (HRA) is a bone-conserving alternative to total hip arthroplasty (THA) for young, active patients with advanced hip disease. Understanding the long-term outcomes and factors influencing survivorship is crucial, particularly as female patients and those with smaller components are at increased risk for implant failure.

Data Highlights

No numerical data or trial data provided in the source material.

Key Findings

• Survivorship rates for HRA after 20 years are 96.5% for men and 87.0% for women.
• By 25 years, survivorship rates decrease to 89.5% for men and 66.9% for women.
• Female sex, smaller component size, and developmental dysplasia of the hip (DDH) are identified as risk factors for failure.
• Dysplasia alone does not constitute a contraindication to resurfacing when adjusted for sex and component size.
• Long-term outcomes for non-OA causes, including avascular necrosis (AVN), remain inadequately defined.

Clinical Implications

The findings emphasize the need for careful patient selection in HRA, particularly for female patients and those with smaller components. Clinicians should consider these factors when discussing surgical options and potential outcomes with patients.

Conclusion

This study highlights the importance of understanding the long-term outcomes of HRA, particularly in at-risk populations, to inform clinical decision-making and improve patient care.

Related Resources & Content

1. Subbiah Ponniah et al., Journal of Orthopaedic Surgery, 2023 -- Long-term Outcomes of Hip Resurfacing Arthroplasty
2. Outcomes and Survival Rates of a Modular Uncemented Revision Stem System in Hip Arthroplasty: A Decadal Study in a Vulnerable Patient Population at a Single Institution
3. Archives of Orthopaedic and Trauma Surgery (Springer) — Mid- to long-term outcomes and survival of total hip arthroplasty using a Kerboull-type acetabular reinforcement plate: an analysis of associated factors
4. Outcomes of Cementless Modular Stem Utilization in Femoral Revision for Total Hip Arthroplasty: An 8-Year Clinical and Radiological Assessment
5. Evaluating Mid-term Outcomes of Cementless Hip Stems in Femoral Revision: Determining the Required Diaphyseal Press-Fit
6. Information for Orthopaedic Surgeons | FDA
7. Outcomes after joint replacement 2003 to 2024 - The National Joint Registry 22nd Annual Report 2025
8. Seventeen-year outcomes for a contemporary total hip resurfacing prosthesis in Australia: an analysis of registry data with comparison to best performing conventional and most prevalent resurfacing prostheses - PubMed
9. Risk factors for revision of Birmingham Hip Resurfacing arthroplasty. A single-center study with a median 13-year follow-up - ScienceDirect
10. Balancing Risk and Reward in Hip Resurfacing for Developmental Dysplasia of the Hip: A Systematic Review and Meta-Analysis - PubMed
11. Outcomes of metal-on-metal hip resurfacing arthroplasty: a single-surgeon series of 6114 cases with 2–19 year follow-up - PMC