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METAL ON METAL HIP RESURFACING. EARLY EXPERIENCE



Abstract

Introduction: Historically Surface Replacement of the Hip exhibited a high failure rate due to femoral head loosening attributed to polyethylene wear debri, originating from the acetabulum. A metal on metal bearing resurfacing prosthesis has been developed to address this problem.

The authors’ early experience using this prosthesis is presented.

Material and methods: 48 patients underwent metal on metal hip Resurfacing Arthrolplasty (Cormet 2000R Corin U.K.) of the hip between 1999–2001. 43 patients suffered from osteoarthritis and 3 from avascular necrosis.

29 males and 19 females underwent the procedure with a mean age of 60 years (45–74).

In 20 hips a posterior approach was used and in 28 our saggital trochenteric osteotomy.

A cementless prosthesis was implanted in 30 patients and the femoral prosthesis was cemented in 18 patients.

Results: All but two patients had an improved hip score with 95 % of the patients reporting a good to excellent result. There were 2 femoral neck fractures one early and one late. One patient had severe heterotrophic ossification and one a transient partial sciatic nerve palsy.

Discussion: Conservative Hip Arthroplasty with Femoral Head and acetabular resurfacing is an attractive concept. Violation of the upper femoral canal is prevented and bone stock is preserved. Improved applications of metallurgical and tribological principles increases the predictability of metal on metal bearing surface function and prevents the catastrophic polyethylene wear previously observed in hip resurfacing procedures.

The principles of metal on metal bearing surfaces, Resurfacing Arthroplasty of the hip and the early clinical results and complications are discussed.

The abstracts were prepared by Orah Naor. Correspondence should be addressed to him at the Israel Orthopaedic Association, PO Box 7845, Haifa 31074, Israel.