Hip Resurfacing Arthroplasty Versus Total Hip Arthroplasty For Osteoarthritis: A Systematic Review

Objective: To assess the effects of hip resurfacing arthroplasty(HRA)and total hip arthroplasty(THA)in the therapy of hip osteoarthritis by systematic review,compare the differences between the two surgical modalities to better develop clinical decisions.Methods: The MEDLINE,EMBASE and Cochrane Collaboration database were searched from establishment to June,2016.The papers and conference materials published in Chinese orthopedics journals were retrieved manually.The relevant randomized controlled trials were collected and the literatures were filtered according to the inclusion and exclusion criteria.The quality of the literatures was evaluated and the data was analyzed using the Review Manager5.3 software provided by the Cochrane Collaboration.Results: A total of 8 randomized controlled trials were assessed.Of the total of 720 patients,355 received surface hip arthroplasty and 365 received total hip arthroplasty.Meta analysis showed that WOMAC pain score in the HRA group was significantly higher than in the THA group at 1 year aftersurgery[MD=-1.98,95%CI(-3.74,-0.22),P=0.03].There was no significant difference between the two groups at 6 months,2 years and 5 years after operation(P> 0.05).The SF-36 quality of life score of the THA group was higher than that of the HRA group at 6 months after operation.There was no significant difference in the rest of the follow-up period.There was no significant difference in Harris function score,revision rate and postoperative complication rate between the two groups(P> 0.05).Compared with THA group,HRA group had longer operative time(P <0.0001)and more blood loss volume(P = 0.02).Conclusion: HRA had a predominant benefit in the 1-year postoperative pain score,but the quality of life score at 6 months postoperatively was inferior to THA,but there was no significant difference between the two groups during the follow-up period.There was no significant difference in the functional score,revision rate and complication rate between the two groups.HRA group had longer operative time and more blood loss volume.