2015 ISAKOS Biennial Congress ePoster #821
Treatment of Osteonecrosis of the Femoral Head With Focal Anatomic Resurfacing Implantation: Preliminary Results of a Novel Option
Onur Bilge, MD, Assoc. Prof., Konya TURKEY
Mahmut N. Doral, MD, Prof., İstanbul, Pendik TURKEY
Nazim Karalezli, Assoc. Prof., Konya TURKEY
Mustafa Yel, prof.MD, Konya TURKEY
Anthony Miniaci, MD, FRCSC, Chagrin Falls, OH UNITED STATES
Konya Necmettin Erbakan University Meram Faculty of Medicine Department of Orthopaedics and Traumatology, Konya, TURKEY
FDA Status Cleared
Summary: In the present study, the novel technique of focal anatomic hip resurfacing with HemiCAP yielded preliminary successful results for the treatment of osteonecrosis of the femoral head. Although preliminary results are promising, further long-term randomized clinical trials with higher number of patients are warranted before its routine clinical use.
The optimal treatment of osteonecrosis of the femoral head has not been established yet. The aim of this study is to report preliminary clinical results of focal anatomic resurfacing implantation for the treatment of osteonecrosis of the femoral head.
Five patients (four male, one female) with seven surgical procedures, ages between 37 and 52 with an average age 45.2 (+/- 7.2) were diagnosed as femoral head avascular necrosis with ragiography and magnetic resonance imaging. They were unresponsive to conservative management or had failed previous surgical treatments and were treated with a focal anatomic femoral head resurfacing between the years 2011-2012. Their relevant data were retrospectively reviewed. Five patients with at least two years follow-up, one left hip, two right hips and two patients with bilateral hip surgery were included in this review. After trochanteric filp osteotomy and safe surgical dislocation of the hip anteriorly, full exposure of the femoral head was established. Thereafter, a focal resurfacing implant matching patients' anatomy and their femoral heads' curvature was performed. Neither complications nor revision ensued intraoperatively and postoperatively. VAS and Harris Hip Scores were recorded both preoperatively and at postoperative 2 years for all 7 surgeries.
The mean follow-up period was 26.6 +/- 3.8 months (range between 24-33 months). The mean VAS scores were 8.9 +/- 0.9 preoperatively and 2.3 +/- 1.0 postoperatively at year two (p=0.017). Harris Hip Scores at postoperative follow up were found to improve significantly to good-excellent scores (86.0 +/- 7.9), compared with preoperative poor scores (26.7 +/- 11.8) (p=0.018).
In the present case series, the novel technique of focal anatomic hip resurfacing with HemiCAP yielded preliminary successful results for the treatment of osteonecrosis of the femoral head.