Legg-Calve-Perthes and slipped capital femoral epiphysis may result in alterations of the proximal femoral morphology, leading to the development of secondary hip osteoarthritis as a young adult. Hip surface arthroplasty presents special technical challenges in these patients because of the abnormal anatomy of the head and neck. We reviewed the radiographic and clinical results of patients with a history of either LCP or SCFE, who underwent hip resurfacing between 1996 and 2002. Twenty-three patients (25 hips, 14 with LCP and 11 with SCFE) underwent metal-on-metal surface arthroplasty. The average age at the time of surgery was 38.1 years and 87% of the patients were male. The mean time to follow-up was 26.9 months. UCLA pain, walking, function, and activity scores improved significantly in both groups as well as the SF-12 physical component scores. One patient with LCP required bilateral conversion to THA at 55 months postoperatively secondary to femoral component loosening. There were no dislocations or femoral neck fractures in this series. Of 11 patients who presented leg length discrepancies preoperatively, limb length was postoperatively equalized in six patients, 3 were maintained with the same amount of discrepancy, and 2 decreased their discrepancy by at least 1 cm. In Charnley Class A patients, there was no difference in femoral offset between the operated and the disease-free, contralateral hip after reconstruction.

Despite the challenges in performing hip resurfacing in this patient population, the results to date have been encouraging. Even with the limitations of resurfacing in restoring leg length and offset, the clinical results of this group of patients are comparable to those of the other etiologies.