Hip resurfacing with preservation of femoral head blood supply

Griffiths, David; Acton, Kerry; Hull, J.B.

doi:10.1016/s1479-666x(08)80075-3

Cited by 8 publications

(4 citation statements)

References 6 publications

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“…This is most likely due to appropriate patient selection for resurfacing surgery across the population, mitigating the increased risk expected in older patients. Despite debate in the literature regarding the most appropriate surgical approach, [26][27][28] in this analysis there was no significant difference between posterior and anterolateral approaches in terms of the risk of revision.…”

Section: Discussionmentioning

confidence: 66%

Independent predictors of revision following metal-on-metal hip resurfacing

Jameson

Baker

Mason

et al. 2012

The Journal of Bone and Joint Surgery. British volume

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Modern metal-on-metal hip resurfacing has been widely performed in the United Kingdom for over a decade. However, the literature reports conflicting views of the benefits: excellent medium- to long-term results with some brands in specific subgroups, but high failure rates and local soft-tissue reactions in others. The National Joint Registry for England and Wales (NJR) has collected data on all hip resurfacings performed since 2003. This retrospective cohort study recorded survival time to revision from a resurfacing procedure, exploring risk factors independently associated with failure. All patients with a primary diagnosis of osteoarthritis who underwent resurfacing between 2003 and 2010 were included in the analyses. Cox's proportional hazard models were used to analyse the extent to which the risk of revision was related to patient, surgeon and implant covariates. A total of 27 971 hip resurfacings were performed during the study period, of which 1003 (3.59%) underwent revision surgery. In the final adjusted model, we found that women were at greater risk of revision than men (hazard ratio (HR) = 1.30, p = 0.007), but the risk of revision was independent of age. Of the implant-specific predictors, five brands had a significantly greater risk of revision than the Birmingham Hip Resurfacing (BHR) (ASR: HR = 2.82, p < 0.001, Conserve: HR = 2.03, p < 0.001, Cormet: HR = 1.43, p = 0.001, Durom: HR = 1.67, p < 0.001, Recap: HR = 1.58, p = 0.007). Smaller femoral head components were also significantly more likely to require revision (≤ 44 mm: HR = 2.14, p < 0.001, 45 to 47 mm: HR = 1.48, p = 0.001) than medium or large heads, as were operations performed by low-volume surgeons (HR = 1.36, p < 0.001). Once these influences had been removed, in 4873 male patients < 60 years old undergoing resurfacing with a BHR, the five-year estimated risk of revision was 1.59%. In summary, after adjustment for a range of covariates we found that there were significant differences in the rate of failure between brands and component sizes. Younger male patients had good five-year implant survival when the BHR was used.

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Section: Discussionmentioning

confidence: 66%

Independent predictors of revision following metal-on-metal hip resurfacing

Jameson

Baker

Mason

et al. 2012

The Journal of Bone and Joint Surgery. British volume

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“…In the treatment of femoral hip fractures, the sequelae of most concern are femoral neck nonunion and avascular necrosis [12]. These sequelae are also of great concern in hip resurfacing in patients with hip osteoarthritis [13].…”

Section: Discussionmentioning

confidence: 99%

Total cross-sectional area of the femoral neck nutrient foramina measured to assess arterial vascular beds in the femoral head

et al. 2019

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BackgroundA detailed understanding of the blood supply to the femoral head is required to plan the surgery in the femoral neck and head area. However, information about the blood vessel networks in the femoral head is inadequate.MethodsThe surface of the femoral neck of 100 dry cadaveric adult femur specimens was scanned using a 3D scanner. The scanning distance was 200 mm, precision 0.01 mm, and measuring point 0.04 mm. The images were acquired at a resolution of 1,310,000 pixels. Digital imaging data were recorded from the femoral neck surface. The diameters of the nutrient foramina of the superior, inferior and anterior retinacular arteries, and the ligamentum teres arteries were determined and divided into five groups.ResultsThe mean cumulative cross-sectional area of the nutrient foramina was as follows: canals of the superior, inferior, anterior, and ligamentum retinacular arteries were 15.59 mm2, 3.63 mm2, 4.32 mm2, and 1.58 mm2, respectively. Next, we analyzed the canals of the superior, inferior, anterior and ligamentum retinacular arteries, respectively, via 3D scanner. We found that the canals of the superior retinacular arteries appear to supply more blood to the femoral head than the canals of the other three types of arteries.ConclusionsOur results demonstrated that surgeries of the femoral neck and femoral head will be improved with prior 3D scanning and lead to better outcomes in surgeries involving the hip area.

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“…18,19 A trochanteric osteotomy with a maximal thickness of about 1.5 cm is made along a line from the posterosuperior edge of the greater trochanter extending distally to the posterior border of the ridge of vastus lateralis. This technique is most commonly used in hip preserving surgery, but has been described for resurfacing procedures.…”

Section: Other Approachesmentioning

confidence: 99%