Surface arthroplasty for osteonecrosis of the hip: hemiresurfacing versus metal-on-metal hybrid resurfacing.
Eighty-four hips with Ficat stage III and IV osteonecrosis were treated: 56 with metal-on-metal surface arthroplasty (MMSA) and 28 with hemi-surface arthroplasty (HSA). Average follow-up was 4.9 years. UCLA hip scores were significantly better for MMSA versus HSA for function and activity as well as Harris Hip scores and physical component of the SF-12 scores. In the MMSA group, 2 hips were revised to total hip arthroplasty for femoral loosening, and 5 hips had adverse radiological changes. In the HSA group, 4 hips were revised (1 sepsis and 3 for pain). There was no evidence of any femoral loosening or neck narrowing in the HSA group. Although the functional clinical outcome of MMSA is superior to HSA, long-term follow up of MMSA will determine the reliability of the femoral fixation.
Beaulé
Paul E
PE
Department of Orthopedics, David Geffen School of Medicine at UCLA, Los Angeles, California 90007, USA.
Amstutz
Harlan C
HC
Le Duff
Michel
M
Dorey
Frederic
F
D000293:Adolescent; D000328:Adult; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation