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Hemiresurfacing: A Surgical Solution for Osteonecrosis in Young Patients

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Hemiresurfacing, a type of surface hemiarthroplasty fixed with cement, is indicated for patients with Stage III avascular necrosis (AVN) and minimal acetabular damage. A study involving 29 patients showed a significant improvement in Harris Hip Score, from 48.1 to 79.3, after a follow-up of 34 months. Despite some revision rates and pain relief outcomes, hemeresurfacing is considered a viable alternative for young patients experiencing bone necrosis with a preserved acetabulum. It allows for minimal bone resection and can delay the need for total hip arthroplasty (THA).

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Hemiresurfacing: A Surgical Solution for Osteonecrosis in Young Patients

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  1. HEMIRESURFACING M. E. Cabanela, M.D.Professor of Orthopedic SurgeryMayo Clinic College of MedicineRochester, Minn.

  2. HEMIRESURFACING • Surface hemiarthroplasty fixed with cement • Best indication: Stage III AVNwith minimal acetabular damage

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

  4. HEMIRESURFACINGDemographics 2-1997 - 4-2000 29 conseiccutive pts 18 m/10 f 31.6 yrs (12-48) Hip pain 23 mos (6-96 mos) Etiology: steroid 16 • ETOH 2 • other 5 • None 4 F-up 34 mos (24-63)

  5. HEMIRESURFACINGResults • HHS 48.1 - 79.3 • Survivorship 93.5% @ 1 yr • 75.9% @ 3 yrs • Revision to THA 8 hips (27.6%) • Pain in groin 4 hips (14%) • Satisfactory pain relief 62.5% @ 3 yrs

  6. HEMIRESURFACINGLiterature Review • Hungerford 91% survival @ 5 yrs 71% @ 10 yrs • Beaulé 79% revision free @ 5 yrs 59% @ 10 yrs • Nelson 82% success @ 6.2 yrs • Mont 90% survival @ 7 yrs

  7. HEMIRESURFACINGAdvantages • Minimal bone resection • Revision to THA not compromised • No EHDP • Can delay THA • Can be satisfactory interim solution

  8. HEMIRESURFACINGConclusions • Unpredictable pain relief • Acceptable alternative in young pt with ON and preserved acetabulum

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