Hip resurfacing for osteonecrosis

Abstract

To our knowledge, this is the first report of a series of HRA performed for ON with 15-year survivorship. Our data confirm that patients with advanced stages of ON of the femoral head are excellent candidates for HRA. Cite this article: Bone Joint J 2016;98-B:901-9.

Risk factors for wear-related failures after hip resurfacing in patients with a low contact patch to rim distance

“…Introduced in the late 1990s, metal-on-metal hip resurfacing arthroplasty (MMHRA), from various manufacturers, has become an alternative to traditional total hip arthroplasty, with comparable mid-to long-term implant survivorship in selected patient populations. [1][2][3][4][5][6] One of the main concerns with MMHRA has been the occurrence of elevated blood cobalt and chromium ion concentrations 7,8 which have been associated with the development of adverse local tissue reactions (ALTR). [9][10][11] A low contact patch to rim (CPR) distance 12 (the distance between the centre of the area of contact between the femoral head and the acetabular component to the acetabular rim) places the articulation at risk for edge-loading and excessive wear, 13 resulting in elevated blood metal ion concentrations.…”

Mid-to-long-term Results of Hemi-resurfacing Arthroplasty and Metal-on-metal Hip Resurfacing Arthroplasty for Osteonecrosis of the Femoral Head

“…Osteonecrosis of the femoral head (ONFH) with collapse is problematic for orthopedic surgeons. Hemiresurfacing arthroplasty (Hemi) and metal-on-metal hip resurfacing arthroplasty (HRA) are alternatives to conventional total hip arthroplasty (THA) for patients with ONFH [1][2][3]. In a nationwide study from the United States, THA was clearly the most commonly performed (90%), while HRA (0.2%) and osteotomy (1%) were performed markedly less frequently [4].…”

“…In Japan, patients who underwent osteotomy and bipolar hip arthroplasty for ONFH decreased, while those who underwent THA increased over time [6]. Hemi and HRA offer potential advantages of preserving bone, loading of the proximal femur, reduced risk of dislocation, and elimination of polyethylene debris that causes osteolysis compared with conventional THA [3,7,8]. In cases of femoral component failure, revision might be simpler compared with conventional THA and could not adversely affect the outcomes of THA [8,9].…”

Tratamiento de la osteonecrosis de la cabeza femoral mediante la administración de células mesenquimales autólogas

“…La AS se basa, por tanto, en la máxima conservación de hueso posible. Es considerado un proceso para prolongar la estabilidad clínica, mediante la mejora de la función y la sintomatología, hasta que el proceso degenera y hace necesaria definitivamente la ATC 122 . La AS parcial, al igual que la artroplastia parcial de cadera, se usa raramente debido a que la presión de carga de una superficie de metal sobre el cartílago acetabular es mal tolerado y el índice de revisión parece ser mayor 123 .…”