TP6.3 Resurfacing vs Total Hip Arthroplasty in Patients Under 50 Years Old: 10-Year Outcomes Using iHOT-33 and HOS Scores

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ID: 331384
2026
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Abstract
Abstract Introduction Total hip arthroplasty (THA) and hip resurfacing are surgical options for young patients with advanced degenerative hip disease. In patients under 50 years old, high functional and sports demands challenge outcome assessment, as traditional scales often show a ceiling effect. Patient-reported outcome measures (PROMs) such as the iHOT-33 and HOS provide more sensitive functional evaluation. This study aimed to compare 10-year functional outcomes in patients under 50 undergoing hip resurfacing or ceramic-on-ceramic THA. Materials and Methods A prospective observational study with retrospective data collection was conducted including 37 patients under 50 years: 17 underwent metal-on-metal hip resurfacing and 20 ceramic-on-ceramic THA. All procedures were performed by the same surgical team. Functional outcomes were assessed preoperatively and at 10 years using iHOT-33 and HOS (Function and Sports subscales). Mean improvements, minimal clinically important difference (MCID), and substantial clinical benefit (SCB) were calculated. Results Mean follow-up was at least 10 years; 70.3% were male. Mean improvements were 52.3 (iHOT-33), 37.5 (HOS-Function), and 31.1 (HOS-Sports). In the THA group, MCID was achieved in 90%, 85%, and 75%, and SCB in 94.2%, 75%, and 60%, respectively. In the resurfacing group, MCID was achieved in 70%, 88.2%, and 64.7%, and SCB in 76.5%, 70.6%, and 52.9%. No statistically significant differences were found between groups. Conclusions Both procedures provide sustained functional benefits at 10 years. iHOT-33 and HOS are sensitive tools for detecting clinically meaningful improvements in young, active patients.
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Authors Resident Laura Plaza Martínez, Resident Beatriz Martín Vélez, Resident Claudia Santafe Campos, Ricardo Larrainzar Garijo, J Lozoya, Miguel Cañones Martín, Oliver Marin Peña
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.166
URL
https://doi.org/10.1093/jhps/hnag043.166
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