Sex as a Patient Selection Criterion for Metal-on-Metal Hip Resurfacing Arthroplasty

Short-term to midterm results of hip resurfacing arthroplasty suggest various contraindications, in particular the female sex. This study evaluates survivorship and clinical outcomes of a large patient cohort to determine whether sex itself has a detrimental effect on the results of hip resurfacing. We compared the clinical and survivorship results of men and women from a series of 1107 resurfaced hips in 923 patients (681 males and 242 females). Women saw greater positive changes in walking, function, and the mental component of the Short Form-12. There was no difference in complication rates between men and women. Although the revision rate was higher in the women’s group, the effect of sex disappeared when adjusted for component size and surgical technique. These data suggest that there is no appreciable effect of sex on implant survivorship and that women may be excellent candidates for resurfacing with proper surgical technique. This is a level III, retrospective comparative study.