Hip Resurfacing 'Unacceptable for Women': Study
Unacceptable for Women, Researcher Says continued...
The researchers also write that their findings cannot simply be explained by the use of smaller head sizes, since women fared worse than men even with the same head size. Women might have a higher risk of osteoporotic fractures in the thigh bone, or they may be more susceptible to complications from metal-on-metal prostheses.
The researchers acknowledge that surgeons will need to weigh other factors when assessing whether hip resurfacing is suitable for a patient, such as the relative benefits of total hip replacement and resurfacing surgery on patient function and quality of life.
In an editorial to the study, Art Sedrakyan, MD, PhD, of Weill Cornell Medical College in New York, said: "Regulators and surgeons need to make proper recommendations for patients, such as not using resurfacing in women, and developing decision aids for patients to convey the benefits, harms, and uncertainty related to second surgery with large metal-on-metal implants."
Nicola Lennard, MD, the deputy clinical director of the Medicines and Healthcare products Regulatory Agency in the U.K., says: "Decisions about what hip implants to use in patients are made by clinicians after careful consideration of the risks and benefits for each individual patient. This involves taking into account the patient’s age, gender, and activity level. For some patients a resurfacing hip implant may be the most clinically appropriate implant for them.
"The use of these hip resurfacing implants has fallen from about 11% in 2006 to about 2.5% in 2011, and only about one in six hip resurfacings were carried out on women in 2011. This change is a result of a better understanding by clinicians of the risks and benefits of hip resurfacing compared with other kinds of hip replacements in different patient groups."