Hip Resurfacing Arthroplasty in Inflammatory Arthritis: A 3- to 5-Year Follow-up Study

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Abstract

The success of hip resurfacing in younger patients with primary osteoarthritis has paved the way for the trial of the procedure in patients with secondary osteoarthritis of the hip. We retrospectively reviewed the clinical and radiologic results in a cohort of 23 patients (32 hips) with inflammatory arthritis who were chosen for hip resurfacing after normalizing vitamin D levels and ruling out proximal femoral osteopenia using dual-energy x-ray absorptiometry. At a minimum follow-up of 3 years, there was failure in only 1 hip due to fracture of the femoral neck attributable to osteonecrosis of the remnant head. The clinical outcome was evaluated using Harris hip score and was found to be good to excellent in 30 of 31 hips. Hip resurfacing is a promising alternative in carefully chosen patients with inflammatory arthritis.

Section snippets

Materials and Methods

A retrospective review of the patients who underwent hip resurfacing between January 2004 and August 2006 revealed 49 hip resurfacings in 37 patients. Of these, 32 hips in 23 patients were resurfaced for disabling inflammatory arthritis of the hip. Painful or stiff joints hindering activities of daily living were the primary indication for hip resurfacing. The serum level of 25(OH)D3 was estimated in all patients before resurfacing because of the association of vitamin D deficiency with

Results

The demographic profile of the patients is listed in Table 1. The mean age of study cohort of young adults was 33 years, with a range of 21 to 48 years. Preoperatively, 4 of the patients were bedridden, whereas the rest were ambulatory, dependent on walking aids. Twenty-two of the 23 patients had suboptimal 25(OH)D levels and had undergone vitamin D therapy before resurfacing. Nine patients underwent bilateral hip resurfacing, of which 7 underwent single-stage resurfacing, whereas 2 patients

Discussion

After the improvements in surgical technique and metallurgy, third-generation total hip resurfacing with metal-on-metal articulation has been successfully introduced in younger patients with primary osteoarthritis of the hip with promising short- to medium-term results 14, 19, 20, 21. Success of the technique in primary osteoarthritis has prompted experimentation of the viability of this unique design in patients with osteoarthritis secondary to osteonecrosis of the femoral head 22, 23,

Acknowledgement

We are grateful to Director-Professor Dr. Virendra N. Sehgal, MD, FNASC, FAMS, FRAS (Lond), who reviewed and meticulously edited this article.

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    The Conflict of Interest statement associated with this article can be found at doi:10.1016/j.arth.2011.02.016.

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