Resurfacing arthroplasty of the hip for avascular necrosis of the femoral head: A MINIMUM FOLLOW-UP OF FOUR YEARS

• Published in: Journal of bone and joint surgery. British volume Vol. 92; no. 7; pp. 922 - 928
• Main Authors: BOSE, V. C, BARUAH, B. D
• Format: Journal Article
• Language: English
• Published: London British Editorial Society of Bone and Joint Surgery 01.07.2010
• Subjects: Adolescent; Adult; Age Distribution; Aged; Arthroplasty, Replacement, Hip - methods; Biological and medical sciences; Diseases of the osteoarticular system; Female; Femur Head Necrosis - diagnostic imaging; Femur Head Necrosis - surgery; Follow-Up Studies; Hip Joint - diagnostic imaging; Hip Prosthesis; Humans; Male; Medical sciences; Middle Aged; Orthopedic surgery; Prosthesis Failure; Radiography; Sex Distribution; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Survival Analysis; Treatment Outcome; Vascular bone diseases; Young Adult; Hip prosthesis; Resurfacing arthroplasty; Orthopedic surgery; Treatment; Aseptic osteonecrosis; Diseases of the osteoarticular system
• ISSN: 0301-620X; 2044-5377
• DOI: 10.1302/0301-620X.92B7.23639

We performed 96 Birmingham resurfacing arthroplasties of the hip in 71 consecutive patients with avascular necrosis of the femoral head. A modified neck-capsule-preserving approach was used which is described in detail. The University of California, Los Angeles outcome score, the radiological parameters and survival rates were assessed. The mean follow-up was for 5.4 years (4.0 to 8.1). All the patients remained active with a mean University of California, Los Angeles activity score of 6.86 (6 to 9). Three hips failed, giving a cumulative survival rate of 95.4%. With failure of the femoral component as the endpoint, the cumulative survival rate was 98.0%. We also describe the combined abduction-valgus angle of the bearing couple, which is the sum of the inclination angle of the acetabular component and the stem-shaft angle, as an index of the optimum positioning of the components in the coronal plane. Using a modified surgical technique, it is possible to preserve the femoral head in avascular necrosis by performing hip resurfacing in patients with good results.