Long-Term Outcome of Surface Replacement With Comparison to an Age- and Time-Matched Primary Total Hip Arthroplasty Cohort

Surface replacement (SR) was introduced as a bone-conserving alternative to total hip arthroplasty (THA) 3 decades ago, then was abandoned due to polyethylene wear, stress shielding, and loosening. Improved bearing surfaces have renewed interest in SR. This study examined long-term SR outcome compared to an age- and time-matched THA cohort. Average age was 47 years at index procedure with 16 years follow-up (range, 5-28). Revision rates were 86% and 40% in SR and THA groups, respectively. However, at 20 years, with an end point of either intact SR or primary THA in the SR group, survivorship was 64% ± 6% versus 39% ± 7% unrevised in THA cohort. Contemporary and rapidly changing technology may result in longer-term SR success and improved THA longevity in young patients.