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Thomas P. Gross, MD1 and
Fei Liu, PhD1
Link
http://www.ejbjs.org/cgi/content/abstract/90/Supplement_3/32
1 Midlands Orthopaedics, 1910
Blanding Street, Columbia, SC 29201
Background: Metal-on-metal hip resurfacing with hybrid
fixation has been introduced as an alternative to
standard total hip arthroplasty, especially for
young and active patients. There are few studies
in the literature on the midterm results of
cementless femoral side resurfacing. The purpose of this
study was to present our seven-year clinical
results of a series of twenty cementless
metal-on-metal hip resurfacing procedures.
Methods: Between 1999 and 2000,
eighteen patients (twenty hips) underwent primary
metal-on-metal hip resurfacing with uncemented
femoral and acetabular components. One patient was lost to
follow-up. This left eleven men and six women,
who had a mean age of forty-five years at the
time of surgery. Clinical and radiographic examinations
were performed prospectively, and the results were
analyzed.
Results: The mean duration of
follow-up was 7.4 years. There were four
revisions, none of which was due to aseptic failure
of the femoral component. Two were due to loosening of
the acetabular component, one was due to a late
hematogenous infection, and one was due to
persistent pain despite normal radiographic findings.
The mean preoperative Harris hip score was 54 points,
and it increased to 94 points at the time of the
last follow-up. Radiographic examination of the
hips for which the procedure was successful
revealed no femoral or acetabular radiolucencies, no
migration of any implant, and no osteolysis. The
radiographs of one patient (two hips) showed
substantial narrowing of the femoral necks (a
mean of 12%), which stabilized at three years
postoperatively. This patient had a Harris hip
score of 100 points for both hips at six years.
Conclusions: This study suggests
that cementless femoral fixation may be a viable
alternative to fixation with cement in metal-on-metal
hip resurfacing. Further study of this concept in
larger numbers of patients is warranted
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