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Related Experiment Videos

THARIES resurfacing arthroplasty. Evolution and long-term results.

H C Amstutz, F Dorey, P F O'Carroll

    Clinical Orthopaedics and Related Research
    |December 1, 1986
    PubMed
    Summary

    Hip resurfacing offers a viable alternative to total hip arthroplasty, particularly for younger patients. While not a perfect solution, it preserves bone stock and may increase implant durability.

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    Area of Science:

    • Orthopedic Surgery
    • Biomaterials Engineering

    Background:

    • Total hip arthroplasty (THA) has shown limitations in young patients.
    • Hip resurfacing, specifically Total Hip Articular Replacement by Internal Eccentric Shells (THARIES), was developed to address these limitations.
    • The primary goals are bone stock preservation and enhanced durability in younger individuals.

    Observation:

    • A study of 584 hips (average age 48) with 1-10 year follow-up revealed a 12.3% failure rate.
    • Loosening, primarily on the acetabular side, was the most common failure mode (66 cases).
    • Other failures included neck fractures and sepsis.

    Findings:

    • Survivorship analysis identified patient age as the most significant factor in prosthesis failure, followed by diagnosis and surgeon experience.

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  • Favorable diagnoses included osteoarthritis and rheumatoid arthritis; unfavorable diagnoses were congenital dysplastic hip, osteonecrosis, and prior failed resurfacing.
  • The femoral component rarely failed, and the femoral head remained vascularized.

    • Implications:

    • Hip resurfacing is a viable alternative to THA, especially for younger patients.
    • The concept is well-suited for the application of porous technology in orthopedic implants.
    • Surgical techniques should emphasize acetabular bone stock preservation and address specific challenges in dysplasia and osteonecrosis.