Resurfacing Arthroplasty in Patients with Osteonecrosis of the Femoral Head
MC Yoo, YJ Cho, KI Kim, YS Chun, JH Ha, JY Park
Department of Orthopaedic Surgery, School of Medicine, Kyung Hee University, Seoul, Korea

Purpose: The resurfacing arthroplasty of the hip joint has advantages of minimal bone resection, restoration of normal anatomy and biomechanical circumstances. This study was undertaken to analyze the clinical and radiographic results of the resurfacing arthroplasty in patients with osteonecrosis of the femoral head (ONFH).

Materials and Methods: Between September 1998 and September 2001, 40 hips of 39 patients with ONFH had a resurfacing arthroplasty with the Birmingham Hip Resurfacing (BHR) system. The mean age at the time of operation was 38.3 years. The average follow-up period was 36.8 months after operation. The patients were clinically evaluated by hip pain, Harris hip scores, and range of motion, and radiographically evaluated the wear, change of cup position, loosening and the osteolysis.

Results: The preoperative Harris hip score were 70.4 points and the degrees of further flexion and internal rotation were 94° and 8° respectively. The average Harris hip score at the last follow-up was 95.4 points. The degrees of further flexion and internal rotation at the last follow-up were 120°, and 20° respectively. No patient complained limb length discrepancy and pain on hip or thigh. Rehabilitation programs and return to normal activities were earlier than that of conventional total hip Arthroplasty (THA). There was no osteolysis, change of cup position, loosening, or detectable wear in the latest radiographic evaluation.

Conclusions: Our experience with resurfacing arthroplasty in the ONFH indicates that the overall results are superior than conventional THA in the aspect of pain relief, range of hip motion, earlier rehabilitation and earlier return to preoperative activity. This procedure with BHR could be an alternative between joint preserving procedure and conventional THA in the case of early-to-mid stage of the ONFH especially in younger patients who need arthroplasty.