Childhood diseases involving the proximal femoral epiphysis often cause abnormalities that can lead to end-stage arthritis at a relatively young age and the need for total hip arthroplasty (THA). The young age of these patients makes hip resurfacing arthroplasty (HRA) an alternative and favorable option due to the ability to preserve femoral bone. Patients presenting with end-stage hip arthritis as sequelae of childhood diseases such as Legg-Calves-Perthes (LCP) and slipped capital femoral epiphysis (SCFE) pose altered femoral anatomy, making HRA more technically complicated. LCP patients can result in coxa magna, coxa plana and coxa breva causing altered femoral head-to-neck ratio. There can also be acetabular dysplasia along with the proximal femoral abnormalities. SCFE patients have altered femoral head alignment. In particular, the femoral head is rotated medially and posteriorly, reducing the anterior and lateral offset. Additionally, many of these patients have retained hardware, making resurfacing more complicated. We report findings of a cohort of patients, with history of either LCP or SCPE who underwent HRA to treat end-stage arthritis. Data was retrospectively collected for patients who had HRA for hip arthritis as a result of either LCP (n=67) or SCFE (n=21) between 2004 and 2014 performed by two surgeons. Demographic information, clinical examination and improvement was collected pre and postoperatively. Improvement was determined using Harris Hip Scores (HHS) and UCLA activity scores. Anteroposterior radiographs were measured pre and postoperatively to determine leg length discrepancy. Radiographs were inspected postoperatively for radiolucent lines, implant loosening and osteolysis. Kaplan-Meier survivorship for freedom from reoperation for any reason was calculated. Paired student t-tests were used to compare groups.INTRODUCTION
METHODS
The optimal surgical treatment for osteonecrosis of the femoral head has yet to be elucidated. To evaluate the role of femoral fixation techniques in hip resurfacing, we present a comparison of the results for two consecutive groups: Group 1 (75 hips) received hybrid hip resurfacing implants with a cemented femoral component; Group 2 (103 hips) received uncemented femoral components. Both groups received uncemented acetabular components. We retrospectively analyzed our clinical database to compare failures, reoperations, complications, clinical results, metal ion test results, and x-ray measurements. Using consecutive groups caused time interval bias, so we required all Group 2 patients be at least two years out from surgery; we compared results from two years and final follow-up.Background
Methods
