Surface Replacement: Better Baggage Gone—Affirms

Despite a resurgence of enthusiasm for resurfacing hip arthroplasty, the procedure may not be as successful as total hip arthroplasty. We reviewed published literature comparing these 2 procedures to better understand the strengths and weaknesses of each. Resurfacing is a more difficult procedure, and few patients meet selection criteria. In addition, there is increased risk of femoral neck fracture, concern over metal hypersensitivity, and poorer range of motion secondary to unfavorable head-to-neck ratio. Multiple studies report no benefit in clinical outcome. In both large comparative meta-analysis studies and joint registry reviews, hip resurfacing had greater failure rates than total hip arthroplasty.