title: Curved-stem hip resurfacing: minimum 20-year followup.
abstract: Hip resurfacing is an attractive concept because it preserves rather than removes the femoral head and neck. Most early designs had high failure rates, but one unique design had a femoral stem. Because that particular device appeared to have better implant survival, this study assessed the clinical outcome and long-term survivorship of a hip resurfacing prosthesis. Four hundred forty-five patients (561 hips) were retrospectively reviewed after a minimum of 20 years' followup or until death; 23 additional patients were lost to followup. Patients received a metal femoral prosthesis with a small curved stem. Three types of acetabular reconstructions were used: (1) cemented polyurethane; (2) metal-on-metal; and (3) polyethylene secured with cement or used as the liner of a two-piece porous-coated implant. Long-term results were favorable with the metal-on-metal combination only. The mean overall Harris hip score was 92 at 2 years of followup. None of the 121 patients (133 hips) who received metal-on-metal articulation experienced failure. The failure rate with polyurethane was 100%, and the failure rate with cemented polyethylene was 41%. Hip resurfacing with a curved-stem femoral component had a durable clinical outcome when a metal-on-metal articulation was used.
authors.affiliation: bonerecon@aol.com
authors.forename: James W
authors.initials: JW
authors.lastname: Pritchett
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D001672:Biocompatible Materials; D001843:Bone Cements / Q000627:therapeutic use; D005270:Femur Head / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D007592:Joint Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008670:Metals; D018579:Patient Selection; D020959:Polyethylene; D011140:Polyurethanes / Q000627:therapeutic use; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials; D001843:Bone Cements; D008670:Metals; D011140:Polyurethanes; D020959:Polyethylene