Corresponding author. Abstract Total hip arthroplasty in the young leads to difficult choices in implant selection. Until recently bone conserving options were not available for younger patients with deficient femoral head bone stock. Femoral neck fracture is a known complication of standard resurfacing arthroplasty and is the most common reason for revision.
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Received May 13; Accepted Jul 1. Abstract Background Hip resurfacing is a conservative type of total hip arthroplasty but its use is controversial, especially in patients with osteonecrosis. The aim of this study was analysis of the clinical and radiographic outcomes of hip resurfacing in patients with osteonecrosis. All patients were evaluated clinically and radiologically before and 60 months after the operation.
No implant migration was observed. Conclusions Management of osteonecrosis of the hip with resurfacing arthroplasty seems to be effective in strictly-selected patients. Avascular necrosis is a progressive condition leading to complete destruction of the hip joint. Usually young, active people between 20 and 50 years of age are affected by the disease and their occupational and physical activity is substantially limited [ 1 — 3 ].
Total hip replacement THR is the criterion standard in the management of end-stage avascular necrosis of the femoral head [ 4 ].
Because of relatively young age and high activity of the patients, the results of THR in this group of patients are not encouraging. Especially, the use of cemented hip endoprostheses results in high rate of revision surgeries [ 5 , 6 ]. Introduction of uncemented total hip arthroplasty significantly improved clinical results [ 7 , 8 ]. Kim et al. Despite good results of uncemented total hip replacement, the lifespan of patients with osteonecrosis of the femoral head exceeds the longevity of the implant and further revision surgeries are usually required.
Thus, conditions leading to increased osteolysis around the implants e. Also, the higher dislocation rate among patients undergoing hip replacement with use of standard mm heads has been unsatisfactory [ 12 , 13 ].
New technologies like total hip resurfacing are a new approach to surgical management of end-stage avascular necrosis of the femoral head.
This study aims to present clinical and radiological outcomes of metal-on-metal hip resurfacing in a series of strictly selected patients with osteonecrosis of the femoral head. Exclusion criteria were: age over 60 years, BMI over 35, bilateral avascular necrosis, other pathologic changes in the contralateral hip, and presence of considerable dysfunction in the musculoskeletal system or any general disabling disease.
The mean age and BMI of the patients were The mean duration of symptoms was 3.
Hip Resurfacing Arthroplasty in Treatment of Avascular Necrosis of the Femoral Head
Birmingham Mid-Head Resection Periprosthetic Fracture