Hip Resurfacing Does Not Improve Proprioception Compared With THA

Background Proposed benefits of total hip resurfacing arthroplasty over total hip arthroplasty (THA) include better proprioception, but this has not been rigorously tested or validated.

Questions/purposes Our purpose was to apply an advanced testing device that objectively quantifies dynamic postural stability to determine if total hip resurfacing is associated with improved proprioception compared with standard or large-head THA.

Methods Three groups of 25 patients (total hip resurfacing, THA femoral head > 32 mm, THA femoral head ≤ 32 mm) and a matched control group were recruited. All participants had UCLA scores ≥ 5 and Harris hip scores ≥ 90 at the time of testing. Testing was conducted using a commercially available device that uses a multidirectional, powered platform to measure deviations of the center of mass and consisted of trials with both double- and single-limb support.

Results Double-limb testing showed no differences between groups. In single-limb testing, the operative side performed better in patients who had undergone total hip resurfacing versus THA, but this difference disappeared when the operative side was normalized to the nonoperative side. When compared with control subjects who had not had arthroplasty, both operative and nonoperative sides showed significantly worse proprioception for all arthroplasty cohorts, suggesting that decreased proprioception is associated with arthritis of the hip in young adults.

Conclusions Total hip resurfacing arthroplasty did not result in improved proprioception compared with THA. These results tend to refute the concept that improved proprioception is a rationale for selecting total hip resurfacing over THA in young patients.

Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.