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Hip Resurfacing Arthroplasty
Hip resurfacing arthroplasty replaces only the diseased portions of the hip joint, whether the femoral head alone or the femoral head and the acetabular surface, using nonmodular components in which the femoral implant matches the inner diameter of the acetabular implant. The optimal patient for hip resurfacing arthroplasty is a young (typically younger than 60 years), active man with osteoarthritis and a history of hip pain. Hip resurfacing in women remains highly controversial. The senior author (P.E.B.) considers women 40 to 50 years of age with degenerative arthritis and a femoral implant size larger than 48 mm to have results that are as good as those of men. Studies of the National Joint Registry for England and Wales and the Australian Orthopaedic Association National Joint Replacement Registry support this opinion. Women younger than 55 years without hip dysplasia represent a small percentage of candidates for hip resurfacing arthroplasty. Patients should be counseled that frequent impact activity can increase the risk of femoral failure. In one study, impact activity was associated with up to a fourfold increase in the revision rate at a mean follow-up of 10 years.