Metal-on-Metal Hybrid Surface Arthroplasty: Two to Six-Year Follow-up Study

Is Resurfacing Arthroplasty Appropriate for Posttraumatic Osteoarthritis?

“…However, resurfacing may have the potential to offer an alternative treatment that can preserve bone and allow surgeons more options when dealing with implanted hardware and deformities. According to the literature, the ideal candidates for resurfacing arthroplasty are male patients, younger than 55 years old, and having a primary diagnosis of osteoarthritis [1,2,14]. Several reports suggest patients with osteonecrosis or developmental deformities of the hip have comparable survivorship to patients with primary arthritis [8,9].…”

“…Hip resurfacing arthroplasty has achieved survivorship of 94% [1,2,14] when the appropriate patient selection criteria are used. Our observations suggest the survivorship in an expanded patient population such as those with posttraumatic osteoarthritis may be similar to these reported survivorships and could be better than those reported for standard THA in these sometimes challenging patient populations.…”

“…Three authors (AJJ, UIM, MAM) independently evaluated all radiographs for radiolucencies using criteria described by DeLee and Charnley [6] for the acetabular component and by various authors for the femoral resurfacing component [1,4]. Any interobserver variability was discussed among the three evaluators until a consensus was reached regarding interpretation.…”

“…Early reports of patients who have received metal-on-metal (MOM) hip resurfacing arthroplasty have demonstrated survival rates from 94% to 99% between 2 and 10 years of followup [1,2,5,9,11,13,14,16]. Although these reports demonstrate an overall high survival rate, it is uncertain if hip resurfacing arthroplasty is a reasonable treatment alternative to total hip arthroplasty (THA) in patients with posttraumatic arthritis of the hip, specifically after femoral neck or acetabular fractures.…”

Activity intensity, assistive devices and joint replacement influence predicted remodelling in the proximal femur

“…Again this has been associated with redirection of joint loading down the implant's metaphyseal stem into the medial neck cortex, bypassing the proximal tissue. This is evidenced by the formation of trabecular pedestal signs around the stem and densification of the medial/distal femoral neck trabecular structures (Amstutz, Beaulé et al 2004;Pollard et al 2006).…”