HEMIRESURFACINGHEMIRESURFACING

M. E. Cabanela, M.D.M. E. Cabanela, M.D.Professor of Professor of

Orthopedic SurgeryOrthopedic SurgeryMayo Clinic College Mayo Clinic College

of Medicineof MedicineRochester, Minn.Rochester, Minn.

• Surface hemiarthroplasty Surface hemiarthroplasty fixed with cementfixed with cement• Best indication: Best indication:

Stage III AVNStage III AVNwith minimal acetabular with minimal acetabular damagedamage

HEMIRESURFACINGHEMIRESURFACING

• Adili A, Trousdale RT: Femoral Adili A, Trousdale RT: Femoral head resurfacing for treatment of head resurfacing for treatment of osteonecrosis in the young osteonecrosis in the young patient. CORR 417:93-101, 2003. patient. CORR 417:93-101, 2003.

HEMIRESURFACINGHEMIRESURFACINGDemographicsDemographics

2-1997 2-1997 - 4-2000- 4-200029 conseiccutive pts29 conseiccutive pts18 m/10 f18 m/10 f31.6 yrs (12-48)31.6 yrs (12-48)Hip pain 23 mos (6-96 mos)Hip pain 23 mos (6-96 mos)Etiology: steroid Etiology: steroid 1616

ETOHETOH 2 2 other other 5 5

None None 4 4F-up 34 mos (24-63)F-up 34 mos (24-63)

HEMIRESURFACINGHEMIRESURFACINGResultsResults

• HHS 48.1 - HHS 48.1 - 79.379.3• Survivorship 93.5% @ 1 yrSurvivorship 93.5% @ 1 yr

75.9% 75.9% @ 3 yrs@ 3 yrs

• Revision to THA 8 hips (27.6%)Revision to THA 8 hips (27.6%)• Pain in groin 4 hips (14%)Pain in groin 4 hips (14%)• Satisfactory pain relief 62.5% @ 3 yrs Satisfactory pain relief 62.5% @ 3 yrs

HEMIRESURFACINGHEMIRESURFACINGLiterature ReviewLiterature Review

• Hungerford 91% survival @ 5 yrsHungerford 91% survival @ 5 yrs 71% @ 10 yrs 71% @ 10 yrs

• BeaulBeaulé 79% revision free @ 5 yrsé 79% revision free @ 5 yrs 59% @ 10 yrs 59% @ 10 yrs

• Nelson 82% success @ 6.2 yrsNelson 82% success @ 6.2 yrs• Mont 90% survival @ 7 yrsMont 90% survival @ 7 yrs

HEMIRESURFACINGHEMIRESURFACINGAdvantagesAdvantages

• Minimal bone resectionMinimal bone resection• Revision to THA not compromisedRevision to THA not compromised• No EHDPNo EHDP• Can delay THACan delay THA• Can be satisfactory interim solutionCan be satisfactory interim solution

HEMIRESURFACINGHEMIRESURFACINGConclusionsConclusions

• Unpredictable pain reliefUnpredictable pain relief• Acceptable alternative in young pt Acceptable alternative in young pt

with ON and preserved acetabulumwith ON and preserved acetabulum