Ceramic resurfacing: postoperative magnetic resonance imaging and clinical outcomes

Hip resurfacing arthroplasty offers a femoral bone preserving procedure that allows high function activities. Understanding what happens to the bone inside the head component in resurfacing has always been limited by metal artefact. The development of ceramic resurfacing has allowed much better visualisation into well-functioning resurfacings. Our aim was to investigate postoperative MRI imaging of ceramic hip resurfacing.

All participants underwent ceramic hip resurfacing using the ReCerf implant (MatOrtho Ltd). All procedures were performed by a single surgeon through an extended posterior approach. Patients underwent MRI at various time frames postoperatively ranging from 4 to 56 months postoperative. Secondary objectives included patient-reported outcomes and complications.

We identified 12 cases involving 9 patients, comprising 6 females and 3 males, with an average age of 46.8 years at the time of resurfacing. The mean follow-up period was 37 (range 13-56) months. The overall findings from the MRI imaging were: 18% (2/11) demonstrated features of avascular necrosis, 27% (3/11) had evidence of femoral neck thinning, no patients had excessive cement mantles. The average Oxford Hip Score prior to the procedure was 24, which increased to 43 following the procedure.

This study represents the first known investigation of ceramic hip resurfacings utilising postoperative MRI imaging. The findings indicate that the residual anatomy of the femoral head and neck can be effectively visualised and interpreted.The application of MRI imaging offers valuable insights into the successes and potential complications associated with this new generation of hip resurfacing procedures.