Outcome of hemiresurfacing in osteonecrosis of the femoral head.
Hemiresurfacing of the femoral head for treatment of osteonecrosis has been proposed as a reasonable alternative to total hip arthroplasty. The results of 59 patients with Ficat Stage III osteonecrosis done by a single surgeon are reviewed. At an average followup of 4.5 years, 16 patients were considered failures because of conversion to total hip arthroplasty or considerable groin pain requiring medication. Failure did not correlate with age, body mass index, preoperative length of symptoms, acetabular articular cartilage status at the time of surgery, or cause of the underlying disease. The only factor associated with failure was a lower preoperative Harris hip score. Conversion of the failed implants to total hip arthroplasty was straightforward, confirming the conservative nature of the procedure. However, pain relief and recovery after resurfacing are less reliable than that associated with total hip arthroplasty. This procedure may be appropriate for patients younger than 30 years, given the ease of conversion to THR if failure occurs. The patient should be counseled regarding expectations.
Cuckler
John M
JM
Division of Orthopaedics, University of Alabama at Birmingham, Birmingham, AL, USA. john.cuckler@ortho.uab.edu
Moore
K David
KD
Estrada
Lance
L
D000328:Adult; D000704:Analysis of Variance; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D002358:Cartilage, Articular / Q000473:pathology / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D005271:Femur Head Necrosis / Q000175:diagnosis* / Q000601:surgery*; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000295:instrumentation / Q000379:methods; D010147:Pain Measurement; D011336:Probability; D011474:Prosthesis Design; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome