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Dr. Beaule
According to Beaulé, the following patient
selection factors can favorably impact modern
resurfacing outcomes:
no large femoral head cyst;
no osteopenia;
younger than 65 years old; and
no prior hip surgery.
"My current ideal indications for hip
resurfacing are patients age less than 60 years,
risk index less than or equal to 3," he said.
The risk index - surface arthroplasty risk index
(SARI) - is a tool for determining how various
factors may interact for a reproducible outcome.
SARI gives two points each for a femoral head
cyst >1 cm3 and patient weight <82 kg, and one
point each for previous hip surgery and UCLA
activity score >6, for a total possible score of
6. The higher the patient’s SARI, the greater
his or her risk of implant failure.
Beaulé applied the index in a study he did of
400 patients following resurfacing arthroplasty.
The overall series showed a survivorship of 94%
at 4 years, which most would consider suboptimal
compared to THA.
After grouping patients by SARI, survivorship
increased to 97% in those with SARI equal to or
less than 3. But it decreased to 89% when the
index was equal to or greater than 3.
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