I have bone cysts, can I have a hip
The presence of a cysts by itself is not a contraindication
for resurfacing. It does not preclude resurfacing automatically.
One must keep in mind that cyst formation is a natural
occurrence in osteoarthritis and is very common though the
extent, quantity & location may vary.
Cysts are of course much more common and invariably present
in AVN. The assessment of certain technical factors would the
real issue. This is based on the amount of residual bone after
head preparation. Some resurfacing prosthesis are thicker at the
top and tend to replace more bone in the head of the femur than
other prosthesis. This is a great advantage in managing cysts as
at the end of head preparation one is left with nearly 100% head
support in a majority of cases. The cysts get reamed away in
bone that would have been removed anyway. The BHR is a good
example of a prosthesis of this type.
The technical criteria which we we have been using in our
centre ( ARCH) for the last 7 yrs without any problems has been
termed as 'mid - path recommendations' because we chose 50% as
an arbitrary value when we started.
1.The criteria are an intact - head neck junction across the
entire circumference to a height of 50% of profile cut ( the
actual height would vary depending on the size used)
2. Residual bone above the intack head neck junction must be
at least 50%
Dr . Sugano from Japan has done an experiment where he removed
50% of head of fresh cadaveric bones and implanted a cemented
resurfacing on them . He also implanted a cemented resurfacing
on an equal amt of fresh cadaveric bones with an intact head. He
compared the mechanical strength of both in the lab and found
the mech. strength to be equal in both groups.
The surgeon has to see the x-rays and CT scan before he can
comment on a particular case.
I have tackled successfully some hips with significant cyst
please see advanced OA with cysts and AVN