Article

Resurfacing for Perthes disease: an alternative to standard hip arthroplasty.

Willamette Orthopedic Group, Salem, OR, USA.
Clinical Orthopaedics and Related Research (impact factor: 2.53). 01/2008; 465:80-5. DOI:10.1097/BLO.0b013e318156bf76 pp.80-5
Source: PubMed

ABSTRACT Metal-on-metal total hip resurfacing is an alternative to conventional total hip arthroplasty with several reports describing the benefits of this procedure in young patients. We retrospectively compared the clinical (including range-of-motion and leg length restoration) and radiographic outcome of resurfacing in young patients with Legg-Calvé-Perthes to those of patients of a similar age treated with a standard total hip arthroplasty. Eighteen patients (19 hip resurfacings) who had a mean age of 33 years (range, 18-34 years) were followed for a minimum of 26 months (mean, 51 months; range, 26-72 months). We used an anterolateral approach in four hips and a posterior approach with a trochanteric advancement in 15 hips. Eighteen of the 19 hips had Harris hip scores greater than 80 points at final followup. All patients improved range of motion while avoiding any clinically apparent impingement. Leg length was gained in 16 hips where preoperative measurements were available. The short-term results of hip resurfacing for the treatment of Perthes disease compare similarly to those found in the literature for standard total hip arthroplasty in young patients. The trochanteric advancement technique described may aid in treating the deformed femoral anatomy.

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    Muthu Ganapathi, Pascal-André Vendittoli, Martin Lavigne, Klaus-Peter Günther
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    Clinical Orthopaedics and Related Research 06/2008; 467(5):1341-7. · 2.53 Impact Factor
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    Article: Is resurfacing arthroplasty appropriate for posttraumatic osteoarthritis?
    Aaron J Johnson, Michael G Zywiel, Uma I Maduekwe, Fei Liu, Michael A Mont, Thomas P Gross
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    ABSTRACT: High survival has been reported for resurfacing arthroplasty in patients with femoral deformities. Also, hardware removal may not always be necessary with resurfacing arthroplasty and may eliminate some of the difficulties performing total hip arthroplasty (THA) in patients with posttraumatic osteoarthritis. We therefore asked: (1) are survivorship higher in patients who underwent resurfacing arthroplasty compared with patients with nontraumatic osteoarthritis; and (2) are those higher compared with all patients who have resurfacing? We identified 29 patients (29 hips) who had hip resurfacing for posttraumatic arthritis. These were compared with a matched cohort who had hip resurfacings for nontraumatic osteoarthritis and to all patients who underwent hip resurfacing for osteoarthritis during this time. The mean age was 47 years and mean body mass index was 27 kg/m(2). Survivorship and Harris hip scores were compared. Radiographs were evaluated for signs of radiolucencies, penciling, or osteolysis. The mean followup was 39 months (range, 24-99 months). The 5-year survivorship was 90% in the posttraumatic group, 93% in the matched osteoarthritis group, and 97% in the entire osteoarthritis cohort. The mean Harris hip score for the posttraumatic group at last followup was 90 points. Other than the patients who underwent revision, we observed no radiographic radiolucencies or loosening in any of the groups. The survival of resurfacing arthroplasty appears comparable to THA in posttraumatic osteoarthritis and for resurfacing in patients with osteoarthritis. Therefore, resurfacing may present an alternative treatment to THA in these patients.
    Clinical Orthopaedics and Related Research 12/2010; 469(6):1567-73. · 2.53 Impact Factor
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Keywords

19 hip resurfacings
 
26 months
 
80 points
 
anterolateral approach
 
clinically apparent impingement
 
conventional total hip arthroplasty
 
deformed femoral anatomy
 
hip resurfacing
 
leg length restoration
 
Metal-on-metal total hip resurfacing
 
posterior approach
 
preoperative measurements
 
range-of-motion
 
reports
 
resurfacing
 
similar age
 
standard total hip arthroplasty
 
trochanteric advancement
 
trochanteric advancement technique
 
young patients