Results of hip resurfacing

Abstract

Background The renewed popularity of resurfacing hip arthroplasty in the last 10 years has generated a remarkable quantity of scientific contributions based on mid-and shortterm follow-up. More than one paper has reported a consistent early revision rate as a consequence of biological or biomechanical failure. Two major complications are commonly described with resurfacing implants: avascular necrosis and femoral-neck fracture. A close relationship between these two events has been suggested, but not firmly demonstrated, whereas cementing technique seems to be better understood as potential cause of failure. Methods We performed an in vitro study in which four different resurfacing implants were evaluated with a simulated femoral head, two types of cement, (low and high viscosity) and two cementing techniques: direct (cement apposition directly on the femoral head) and indirect (cement poured into the femoral component). Results High-viscosity cement showed homogeneous distribution over the entire femoral head. Low-viscosity cement showed a massive polar concentration with insufficient, if not absent, distribution in the equatorial zone. Conclusion Polar cement concentration could be a risk factor for early implant failure due to two effects on the femoral head: biological (excessive local exothermic reaction could cause osteocyte necrosis) and biomechanical (which could lead to uneven load distribution on the femoral head).

Hip resurfacing in patients under thirty years old: an attractive option for young and active patients

“…The main advantages of hip resurfacing include preservation of femoral bone stock, reliable restoration of physiological biomechanics, and a low dislocation rate [14]. In patients under 30 years old, the dislocation rate varied from 0 to 18 % (5 % on average) and differed from our 0 % rate.…”

“…Mean HHS increased from 43.9 (19-67) to 89.3 at last follow-up (55-100). Mean PMA score rose from 11.3 (7-14) to 17 (13)(14)(15)(16)(17)(18) at the last followup (p<0.001). Range of motion was also improved, whatever the angular section (p<0.01) ( Table 2).…”

“…In all these studies, the mean revision rate was significant at 27.4 % (13-43) with a mean follow-up of 10.6 years (5. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. All authors highlighted the greater risk of revision compared to an older and/or less active population [3,13,27,30,31,34,38].…”

“…Patient inclusion was continuous, without randomisation, according to the following criteria: indication for primary hip arthroplasty, age over 18 years and less than 30 years old. During the inclusion period, 24 patients were not enrolled before surgery because of exclusion criteria (Table 1): avascular necrosis of the femoral head (14), chronicle anti-inflammatory treatment (5), and inflammatory disease (5). The study was performed in 23 patients (25 hips).…”

Prevalence of dysplasia as the source of worse outcome in young female patients after hip resurfacing arthroplasty

“…Hip resurfacing arthroplasty (HRA) has gained renewed interest since the application of metal-on-metal bearing surfaces in the 1990s [1][2][3]. The procedure was revisited to address the high failure rates in young patients with standard stemmed total hip arthroplasty (THA).…”