Hip Resurfacing Arthroplasty: Mid-Term Results in 486 Cases and Current Indication in Our Institution

Abstract

In the previous decade, metal-on-metal hip resurfacing has been considered an attractive option and theoretically advantageous over conventional total hip arthroplasty, especially in young active patients. Different authors have reported favourable mid-term clinical and functional results with acceptable survival rates. Proper indication and planning, as accurate technical execution have been advocated to be crucial elements for success.Concerns regarding serum metal ion levels and possible clinical implications have led in the last years to a decline in the use of metal-on-metal hip resurfacing and metal-on-metal bearings in general.The aim of this study is to present the results of our first 486 cases of hybrid hip resurfacing arthroplasties with a second generation cementing technique, and to describe our current restricted indication of this type of prosthesis, in the light of recent findings in the literature about the possible complications related to metallosis or improper patient selection. Global survivorship of our series was 97.9% at a mean follow-up of 7.2 years.In the second season of our experience the indication is restrictive. The candidate for a resurfacing hip replacement is a young and active male patient, with good bone quality, that has been made aware of the risks and benefits of this type of prosthesis.

Improving registration accuracy during total hip arthroplasty: a cadaver study of a new, 3-D mini-optical navigation system

“…Cup accuracy during total hip arthroplasty (THA) is an important and challenging aspect of this procedure. The long-term stability and survival of the artificial joint is governed largely by the proper sizing and implantation of components, with inaccuracies leading to a range of complications, including increased component wear (1, 2), metallosis (3-6), increased risk of instability (7-9), dislocation and revision surgery (10-13). Recent studies suggest that up to 62% of manually implanted acetabular cups are implanted outside of the described “safe zone” (14), and that up to 36.5% of the 50,000 THA revisions that are performed each year in the United States are a result of instability (8, 15).…”

Klubo Sąnarių Paviršių Atnaujinimo Operacija: Indikacijos, Kontraindikacijos, Rezultatai Ir Komplikacijos

“…Lyginant su standartine klubo sąnario artroplastika, operacija tinkama tik pacientams, kurių kaulų mineralinis tankis ir morfologija yra normali. Atnaujinant sąnarinius paviršius, sąnario anatomija nėra keičiama ar koreguojama, o sugrąžinus sąnario funkciją, kaulas turi išlaikyti apkrovas [6,22], todėl laikoma, kad ši chirurginė procedūra tinkamiausia jauniems (<60m.) vyrams, kurių šlaunikaulio galvos diametras yra ne mažesnis kaip 50 mm [1,3,5,6].…”

A new mini-navigation tool allows accurate component placement during anterior total hip arthroplasty

“… 4 – 6 However, patient-related factors, including body mass index (BMI) 7 and anatomical features such as a wide or horizontal iliac wing, 8 as well as surgical factors such as incision size, location, and limited visibility 9 may inhibit the surgeon’s ability to accurately place components during THA. As a result, there is a risk for component malpositioning, a complication that may result in accelerated wear, 10 , 11 instability, 12 , 13 metallosis, 14 , 15 and an increased probability of readmission and revision surgery. 16 – 18 …”