Hip Resurfacing in Patients Who Have Osteonecrosis and are 25 Years or Under

Background Young patients with osteonecrosis (ON) treated with THA often have suboptimal function and radiographic failure with eventual revision. Resurfacing may be an option because of potentially increased functionality and decreased radiographic failure, although neither has been confirmed in the literature.

Questions/purposes We therefore compared the clinical scores and radiographic failures of resurfacing patients 25 years or younger with osteonecrosis with those for patients with ON treated with THA.

Methods We identified 17 patients (20 resurfaced hips) who were 25 years or younger and treated by resurfacing for ON. Mean followup was 62 months (range, 32-103 months). This group was matched by gender, age, BMI, and followup to 16 patients (20 hips) treated with THA with a mean 61 month followup (range, 34-88 months). Additionally, the group was compared to 78 patients (87 hips) with ON over age 25 who underwent resurfacing during the same time with a mean followup of 61 months (range, 27-112 months).

Results The mean Harris score improved from 48 points preoperatively to 93 points with a 100% 7.5 year survivorship in the young resurfacing group. In the THA cohort, the mean score improved from 44 points preoperatively to 94 points postoperatively, with a 93.3% 7.5 year survivorship; similar to the results for all resurfacing patients. Radiographs did not reveal malalignment or progressive radiolucencies in any cohort.

Conclusion At approximately 5 year followup, young resurfacing patients were similar to other resurfacing patients and standard THA patients regarding clinical ratings and radiographic failures.

Level of Evidence Level III, therapeutic study. See Instructions to Authors for a complete description of levels of evidence.