Resurfacing arthroplasty for patients with osteonecrosis.
The suitability of third-generation metal-on-metal hip resurfacing products for patients with a primary diagnosis of osteonecrosis has been debated. The preservation of femoral head bone stock for femoral prosthetic support is essential for the long-term stability of implants. A modern hip resurfacing system was implanted in 1148 hips as part of a United States multicenter investigational device exemption study. Of these, 116 hips had a preoperative diagnosis of osteonecrosis and were compared to 1023 hips with osteoarthritis. Survival rates were not significantly different (95.9% and 95.8% at 24 months for osteoarthritis and osteonecrosis respectively, p = 0.46). Resurfacing arthroplasty for patients with osteonecrosis appears to be a reasonable alternative, taking into consideration implant size, patient gender, and size of femoral deficiency. Further characterization is needed to identify those specific patients with osteonecrosis for whom resurfacing arthroplasty would be appropriate.
Stulberg
Bernard N
BN
Cleveland Clinic, Cleveland, OH, USA. bstulberg.ccjr@sbcglobal.net
Fitts
Stephanie M
SM
Zadzilka
Jayson D
JD
Trier
Kathy
K
D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D002858:Chromium Alloys; D019992:Databases as Topic; D017886:Durapatite; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D053208:Kaplan-Meier Estimate; D019060:Minimally Invasive Surgical Procedures; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000601:surgery*; D010020:Osteonecrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D018579:Patient Selection; D011474:Prosthesis Design; D011859:Radiography; D012720:Severity of Illness Index; D013997:Time Factors; D014025:Titanium; D016896:Treatment Outcome; D014481:United States
D002858:Chromium Alloys; D017886:Durapatite; D014025:Titanium