Avascular necrosis and subsequent femoral neck fracture 3.5 years after hip resurfacing: a highly unusual late complication in the absence of risk factors—a case report

In January 2003 a 63-year-old, otherwise healthy man presented at our department with clinical signs of osteoarthritis of the left hip. Plain radiographs showed osteoarthritis without signs of avascular necrosis (AVN) or osteoporosis (Figure 1A). No previous diseases or trauma had affected the patient’s hip. After preoperative counselling on various surgical options, the patient was scheduled for a hip resurfacing procedure. Regular preoperative investigations showed normal values of hemoglobin, sodium, potassium, prothrombin time international normalized ratio (PTT-INR) and C-reactive protein, and a normal blood pressure was found.