Top

Clinical Orthopaedics and Related Research®

Published in:

01-06-2011 | Symposium: Update on Hard-on-Hard Bearings in Hip Arthroplasty

Hip Resurfacing in Patients Who Have Osteonecrosis and are 25 Years or Under

Authors: Siraj A. Sayeed, MD, Aaron J. Johnson, MD, D. Alex Stroh, BS, Thomas P. Gross, MD, Michael A. Mont, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 6/2011

Abstract

Background

Young patients with osteonecrosis (ON) treated with THA often have suboptimal function and radiographic failure with eventual revision. Resurfacing may be an option because of potentially increased functionality and decreased radiographic failure, although neither has been confirmed in the literature.

Questions/purposes

We therefore compared the clinical scores and radiographic failures of resurfacing patients 25 years or younger with osteonecrosis with those for patients with ON treated with THA.

Methods

We identified 17 patients (20 resurfaced hips) who were 25 years or younger and treated by resurfacing for ON. Mean followup was 62 months (range, 32–103 months). This group was matched by gender, age, BMI, and followup to 16 patients (20 hips) treated with THA with a mean 61 month followup (range, 34–88 months). Additionally, the group was compared to 78 patients (87 hips) with ON over age 25 who underwent resurfacing during the same time with a mean followup of 61 months (range, 27–112 months).

Results

The mean Harris score improved from 48 points preoperatively to 93 points with a 100% 7.5 year survivorship in the young resurfacing group. In the THA cohort, the mean score improved from 44 points preoperatively to 94 points postoperatively, with a 93.3% 7.5 year survivorship; similar to the results for all resurfacing patients. Radiographs did not reveal malalignment or progressive radiolucencies in any cohort.

Conclusion

At approximately 5 year followup, young resurfacing patients were similar to other resurfacing patients and standard THA patients regarding clinical ratings and radiographic failures.

Level of Evidence

Level III, therapeutic study. See Instructions to Authors for a complete description of levels of evidence.

2005 CJJR Report: Total hip and total knee replacement in Canada. Canadian Instititute for Health Information. Available at: http://secure.cihi.ca/cihiweb/products/2005_CJRR_Annual_Report_e.pdf. Accessed December 18, 2009.

Al-Mousawi F, Malki A, Al-Aradi A, Al-Bagali M, Al-Sadadi A, Booz MM. Total hip replacement in sickle cell disease. Int Orthop. 2002;26:157–161.PubMedCrossRef

Amstutz HC, Grigoris P, Dorey FJ. Evolution and future of surface replacement of the hip. J Orthop Sci. 1998;3:169–186.PubMedCrossRef

Amstutz HC, Le Duff MJ. Hip resurfacing results for osteonecrosis are as good as for other etiologies at 2 to 12 years. Clin Orthop Relat Res. 2010;468:375–381.PubMedCrossRef

Aulakh TS, Rao C, Kuiper JH, Richardson JB. Hip resurfacing and osteonecrosis: results from an independent hip resurfacing register. Arch Orthop Trauma Surg. 2010;130:841–845.PubMedCrossRef

Ball ST, Le Duff MJ, Amstutz HC. Early results of conversion of a failed femoral component in hip resurfacing arthroplasty. J Bone Joint Surg. 2007;89:735–741.PubMedCrossRef

Beaule PE, Amstutz HC, Le Duff M, Dorey F. Surface arthroplasty for osteonecrosis of the hip: hemiresurfacing versus metal-on-metal hybrid resurfacing. J Arthroplasty. 2004;19(8 Suppl 3):54–58.PubMed

Beaule PE, Dorey FJ. Survivorship analysis of cementless total hip arthroplasty in younger patients. J Bone Joint Surg Am. 2001;83:1590–1591.PubMed

Brodner W, Grohs JG, Bancher-Todesca D, Dorotka R, Meisinger V, Gottsauner-Wolf F, Kotz R. Does the placenta inhibit the passage of chromium and cobalt after metal-on-metal total hip arthroplasty? J Arthroplasty. 2004;19(8 Suppl 3):102–106.PubMedCrossRef

10.

Cabanela ME. Bipolar versus total hip arthroplasty for avascular necrosis of the femoral head. A comparison. Clin Orthop Relat Res. 1990;261:59–62.

11.

Callaghan JJ, Forest EE, Sporer SM, Goetz DD, Johnston RC. Total hip arthroplasty in the young adult. Clin Orthop Relat Res. 1997;344:257–262.PubMed

12.

DeFrances CJ, Lucas CA, Buie VC, Golosinskiy A. 2006 National Hospital Discharge Survey. Available at: http://www.cdc.gov/nchs/data/nhsr/nhsr005.pdf. Accessed December 18, 2009.

13.

DeLee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res. 1976;121:20–32.PubMed

14.

Dorr LD, Kane TJ, 3rd, Conaty JP. Long-term results of cemented total hip arthroplasty in patients 45 years old or younger. A 16-year follow-up study. J Arthroplasty. 1994;9:453–456.PubMedCrossRef

15.

Engh CA, Massin P, Suthers KE. Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res. 1990;257:107–128.PubMed

16.

Garino JP, Steinberg ME. Total hip arthroplasty in patients with avascular necrosis of the femoral head: a 2- to 10-year follow-up. Clin Orthop Relat Res. 1997;334:108–115.PubMedCrossRef

17.

Graves SE, Davidson D, Ingerson L, Ryan P, Griffith EC, McDermott BF, McElroy HJ, Pratt NL. The Australian Orthopaedic Association National Joint Replacement Registry. Med J Aust. 2004;180(5 Suppl):S31–34.PubMed

18.

Gruen TA, McNeice GM, Amstutz HC. “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res. 1979;141:17–27.PubMed

19.

Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51:737–755.PubMed

20.

Hartley WT, McAuley JP, Culpepper WJ, Engh CA, Jr., Engh CA, Sr. Osteonecrosis of the femoral head treated with cementless total hip arthroplasty. J Bone Joint Surg Am. 2000;82:1408–1413.PubMed

21.

Huo MH, Salvati EA, Browne MG, Pellicci PM, Sculco TP, Johanson NA. Primary total hip arthroplasty in systemic lupus erythematosus. J Arthroplasty. 1992;7:51–56.PubMedCrossRef

22.

Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Amer Statist Assn. 1958;53:457–481.CrossRef

23.

Kim YG, Kim SY, Kim SJ, Park BC, Kim PT, Ihn JC. The use of cementless expansion acetabular component and an alumina-polyethylene bearing in total hip arthroplasty for osteonecrosis. J Bone Joint Surg Br. 2005;87:776–780.PubMedCrossRef

24.

Kim YH, Oh JH, Oh SH. Cementless total hip arthroplasty in patients with osteonecrosis of the femoral head. Clin Orthop Relat Res. 1995;320:73–84.PubMed

25.

Lieberman JR, Berry DJ, Mont MA, Aaron RK, Callaghan JJ, Rajadhyaksha AD, Urbaniak JR. Osteonecrosis of the hip: management in the 21st century. Instr Course Lect. 2003;52:337–355.PubMed

26.

Lieberman JR, Fuchs MD, Haas SB, Garvin KL, Goldstock L, Gupta R, Pellicci PM, Salvati EA. Hip arthroplasty in patients with chronic renal failure. J Arthroplasty. 1995;10:191–195.PubMedCrossRef

27.

McGrath MS, Marker DR, Seyler TM, Ulrich SD, Mont MA. Surface replacement is comparable to primary total hip arthroplasty. Clin Orthop Relat Res. 2009;467:94–100.PubMedCrossRef

28.

Mont MA, Hungerford DS. Non-traumatic avascular necrosis of the femoral head. J Bone Joint Surg. 1995;77:459–474.PubMed

29.

Mont MA, Marker DR, Smith JM, Ulrich SD, McGrath MS. Resurfacing is comparable to total hip arthroplasty at short-term follow-up. Clin Orthop Relat Res. 2009;467:66–71.PubMedCrossRef

30.

Mont MA, Seyler TM, Marker DR, Marulanda GA, Delanois RE. Use of metal-on-metal total hip resurfacing for the treatment of osteonecrosis of the femoral head. J Bone Joint Surg Am. 2006;88 (Suppl 3):90–97.PubMedCrossRef

31.

Mont MA, Seyler TM, Plate JF, Delanois RE, Parvizi J. Uncemented total hip arthroplasty in young adults with osteonecrosis of the femoral head: a comparative study. J Bone Joint Surg Am. 2006;88 (Suppl 3):104–109.PubMedCrossRef

32.

Mont MA, Seyler TM, Ragland PS, Starr R, Erhart J, Bhave A. Gait analysis of patients with resurfacing hip arthroplasty compared with hip osteoarthritis and standard total hip arthroplasty. J Arthroplasty. 2007;22:100–108.PubMedCrossRef

33.

Murzic WJ, McCollum DE. Hip arthroplasty for osteonecrosis after renal transplantation. Clin Orthop Relat Res. 1994;299:212–219.PubMed

34.

Nantel J, Termoz N, Vendittoli PA, Lavigne M, Prince F. Gait patterns after total hip arthroplasty and surface replacement arthroplasty. Arch Phys Med Rehabil. 2009;90:463–469.PubMedCrossRef

35.

Revell MP, McBryde CW, Bhatnagar S, Pynsent PB, Treacy RB. Metal-on-metal hip resurfacing in osteonecrosis of the femoral head. J Bone Joint Surg Am. 2006;88 (Suppl 3):98–103.PubMedCrossRef

36.

Saito S, Saito M, Nishina T, Ohzono K, Ono K. Long-term results of total hip arthroplasty for osteonecrosis of the femoral head. A comparison with osteoarthritis. Clin Orthop Relat Res. 1989;244:198–207.PubMed

37.

Shrader MW, Bhowmik-Stoker M, Jacofsky MC, Jacofsky DJ. Gait and stair function in total and resurfacing hip arthroplasty: a pilot study. Clin Orthop Relat Res. 2009;467:1476–1484.PubMedCrossRef

38.

Stulberg BN, Singer R, Goldner J, Stulberg J. Uncemented total hip arthroplasty in osteonecrosis: a 2- to 10-year evaluation. Clin Orthop Relat Res. 1997;334:116–123.PubMedCrossRef

39.

Ziaee H, Daniel J, Datta AK, Blunt S, McMinn DJ. Transplacental transfer of cobalt and chromium in patients with metal-on-metal hip arthroplasty: a controlled study. J Bone Joint Surg Br. 2007;89:301–305.PubMed

Title: Hip Resurfacing in Patients Who Have Osteonecrosis and are 25 Years or Under
Authors: Siraj A. Sayeed, MD
Aaron J. Johnson, MD
D. Alex Stroh, BS
Thomas P. Gross, MD
Michael A. Mont, MD
Publication date: 01-06-2011
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 6/2011
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-010-1629-5

At a glance: The STEP trials

Springer Medicine

Hip Resurfacing in Patients Who Have Osteonecrosis and are 25 Years or Under

Abstract

Background

Questions/purposes

Methods

Results

Conclusion

Level of Evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Questions/purposes

Methods

Results

Conclusion

Level of Evidence

Please log in to get access to this content

Other articles of this Issue 6/2011

Biographical Sketch: Themistocles Gluck (1853–1942)

Surgical Variables Influence Metal Ion Levels After Hip Resurfacing

Can the Toronto Extremity Salvage Score Produce Reliable Results When Used Online?

Is Total Ankle Arthroplasty A Cost-effective Alternative to Ankle Fusion?

Effects of a Knee Extension Constraint Brace on Lower Extremity Movements after ACL Reconstruction

Functional Recovery Period after Arthroscopic Rotator Cuff Repair: Is it Predictable Before Surgery?