Hip Resurfacing Delivers Comparable Outcomes to THA in Patients 65 and Older

Z. Wong et al. conducted a retrospective, propensity score–matched study comparing Hip Resurfacing Arthroplasty (HRA) and Total Hip Arthroplasty (THA) in patients aged 65 and older.“Total Hip Arthroplasty vs Hip Resurfacing in Patients Over 65: A Propensity Score–Matched Comparison of Patient-Reported Outcomes.” Arthroplasty Today, 2025.doi: 10.1016/j.artd.2025.101721

The aim of this study was to compare outcomes between Total Hip Arthroplasty (THA) and Hip Resurfacing Arthroplasty (HRA) in patients aged 65 and older, with a focus on patient-reported outcome measures (PROMs), implant survival, and complication rates. This study included only male participants, averaging 68.9 years in age and a BMI of 30.

Key Findings:

Activity Levels:

The LEAS score in the study revealed that those who underwent HRA exhibited higher preoperative activity levels, a finding consistent with previous research.  

Metal Ions:

Metal ion levels in the HRA group remained within safe ranges, with no adverse local tissue reactions.

Survivorship:

No revisions were reported in the HRA group. One revision occurred in the THA group due to infection, with 5-year survivorship at 100% (HRA) vs 98.5% (THA).

JM Comments:

This study shows that carefully selected patients over 65 with good bone stock, larger femoral heads, and a higher activity level can see positive comparable outcomes from both Hip Resurfacing and Total Hip Arthroplasty. These findings highlight the growing relevance of HRA as a versatile treatment option for a broader and more diverse aging population.

Reference

Wong Z, Saluja A, Andrew Jordan L, Spaan J, Su E. Total Hip Arthroplasty vs Hip Resurfacing in Patients Over 65: A Propensity Score-Matched Comparison of Patient-Reported Outcomes. Arthroplast Today. 2025 May 29;33:101721. doi: 10.1016/j.artd.2025.101721. PMID: 40510197; PMCID: PMC12162034.