Failure of femoral surface replacement for femoral head avascular necrosis.
The appropriate treatment for the young patient with post-collapse avascular necrosis (AVN) of the femoral head continues to be controversial. Femoral surface replacement (FSR) has emerged as a potential strategy to delay total hip arthroplasty in these patients. Between 1997 and 2003, 37 FSR procedures were performed. Success was defined as patients not requiring revision surgery or having a Harris hip pain score of 30 or greater. Failure was defined as patients having revision surgery or a Harris hip pain score of 20 or less. The overall failure rate based on Harris hip pain scores and revision surgery was 64.8% (24/37 procedures). Fifteen (40.5%) procedures required revision surgery, whereas 9 (24.3%) patients were considered failures based on their pain scores. The purpose of this study was to determine if FSR is a viable option for post-collapse AVN. We conclude that hemiresurfacing for AVN is an unpredictable procedure. This procedure is no longer offered as a treatment option for post-collapse AVN at our institution.
Squire
Matthew
M
University of Wisconsin, Department of Orthopedic and Rehabilitation, Madison, Wisconsin, USA.
Fehring
Thomas K
TK
Odum
Susan
S
Griffin
William L
WL
Bohannon Mason
J
J
D000293:Adolescent; D000328:Adult; D005260:Female; D005271:Femur Head Necrosis / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D017211:Treatment Failure