Conclusions Revisions and reoperations are more frequent and occur earlier with metal-on-metal hip resurfacing , except when discontinued devices are removed from the analyses .
Background Metal-on-metal hip resurfacing was developed for younger , active patients as an alternative to THA , but it remains controversial .
Study heterogeneity , inconsistent outcome definitions , and unst and ardized outcome measures challenge our ability to compare arthroplasty outcomes studies .
Questions / purpose sWe asked how early revisions or reoperations ( within 5 years of surgery ) and overall revisions , adverse events , and postoperative component malalignment compare among studies of metal-on-metal hip resurfacing with THA  among patients with hip osteoarthritis .
Secondarily , we compared the revision frequency identified in the systematic review with revisions reported in four major joint replacement registries .
Patient Relevant Outcomes after total hip replacement. A comparison between different surgical techniques
Objective To investigate differences in pre- and postoperative patient-relevant outcome between hybrid total hip replacement ( THR ) and cemented THR in patients with primary osteoarthritis ( OA ) . Methods 245 consecutive patients were included in the study . 68 of the patients ( mean age 62 ) were operated on with hybrid THR and 177 ( mean age 74 ) were operated on with cemented THR .  All patients were investigated preoperatively and 0.5 , 1 and 3.6 years postoperatively with two self-administered question naires , SF-36 and WOMAC ( Western Ontario and MacMaster Universities Osteoarthritis Index , LK 3.0 ) . Results Preoperatively , there was a difference in the SF-36 subscales RP ( role physical ) and GH ( general health ) where the patients with the hybrid THR attained better scores . At 3.6-years the patients with the hybrid THR reached better scores in all SF-36 subscales except BP ( bodily pain ) and GH . Further , they had better scores in WOMAC function . However , after adjusting for age , sex , follow-up time and baseline values there were no differences in outcome between the two different surgical techniques . Conclusion This medium term ( 3–5 years ) , controlled , open cohort study , using patient-relevant outcome measures , did not reveal any differences between hybrid THR and cemented THR for OA at 3.6 years after surgery . Since the study had 75–94 % power to detect the clinical ly significant score difference of 10 points , we suggest that any difference in outcome between these two methods is small and may require a large-scale , blinded , r and omized trial to show
Conclusions Revisions and reoperations are more frequent and occur earlier with metal-on-metal hip resurfacing , except when discontinued devices are removed from the analyses .
Background Metal-on-metal hip resurfacing was developed for younger , active patients as an alternative to THA , but it remains controversial .
Study heterogeneity , inconsistent outcome definitions , and unst and ardized outcome measures challenge our ability to compare arthroplasty outcomes studies .
Questions / purpose sWe asked how early revisions or reoperations ( within 5 years of surgery ) and overall revisions , adverse events , and postoperative component malalignment compare among studies of metal-on-metal hip resurfacing with THA  among patients with hip osteoarthritis .
Secondarily , we compared the revision frequency identified in the systematic review with revisions reported in four major joint replacement registries .