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Hip resurfacing in patients with severe osteoarthritis and blocked medullary canal

James W Pritchett1

  • 1Wyss Hip and Pelvis Center, Seattle, WA, USA.

Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
|May 30, 2018
PubMed

Insights

Hip resurfacing is a successful alternative to conversion total hip replacement (CTHR) for patients with femoral deformities or retained implants. This canal-sparing approach offers improved outcomes and fewer complications.

Area of Science:

  • Orthopedic surgery
  • Reconstructive surgery
  • Biomaterials engineering

Background:

  • Femoral deformities and retained implants pose challenges for traditional total hip replacement (THR).
  • Conversion total hip replacement (CTHR) can involve increased operative time, blood loss, and complications, especially with intramedullary nail removal.
  • Hip resurfacing offers a potential alternative with a blocked femoral canal, possibly simplifying the procedure and improving outcomes.

Purpose of the Study:

  • To evaluate the effectiveness of hip resurfacing in patients with femoral deformities or retained femoral implants.
  • To compare the perioperative complexity and functional outcomes of hip resurfacing versus CTHR in challenging cases.
  • To assess implant survivorship and the need for revision surgery following hip resurfacing.

Main Methods:

  • Hip resurfacing was performed in 61 patients (65 hips) with a blocked femur, who were previously advised against standard THR.
  • Perioperative data including operative time and blood loss were recorded.
  • Functional outcomes were assessed using the Harris Hip Score (HHS) and Short-Form 12 (SF-12) questionnaire.
  • Implant survivorship was determined by the rate of revision surgery.

Main Results:

  • At a mean follow-up of 9 years, 59 patients were evaluated.
  • Mean operative time was 104 minutes, and mean blood loss was 300 cc.
  • Significant improvements were observed in HHS (41 to 92) and SF-12 scores (physical: 26 to 49; mental: 44 to 54) (p < 0.001).
  • No hip resurfacing procedures required revision surgery.

Conclusions:

  • Canal-sparing hip resurfacing is a successful and less complicated option for patients with femoral canal blockage due to deformity or retained implants.
  • This technique offers a viable alternative to CTHR, demonstrating excellent functional outcomes and long-term survivorship.
  • Hip resurfacing in these complex cases leads to improved patient function and avoids the potential complications associated with CTHR.
Abstract

Keywords:
Blocked femurfemoral deformitiesfemoral implantship resurfacingosteoarthritis

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