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Is there still an indication for the Birmingham Hip Resurfacing in femoral head osteonecrosis?

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Abstract

Purpose

Osteonecrosis of the femoral head (ONFH) is a progressive hip disease. Hip resurfacing arthroplasty (HRA) is a preferred surgical procedure among hip arthroplasty performed in young patients. The aim of this study is to show the long-term clinical and radiological results of HRA procedures performed for patients suffering from ONFH.

Methods

Forty-five patients who underwent hip resurfacing with the diagnosis of femoral head osteonecrosis were included in the study. The Harris Hip Score (HHS) was used for clinical scoring of the patients. The blood chromium, cobalt, white blood cell (WBC) count, and CRP levels of patients were checked. Ultrasonography (USG) was performed for all patients at mid-term control checked for pseudo-tumours. For the radiological evaluation, acetabular inclination, stem shaft angle, prothesis-to-neck ratio, osteolysis zones, and heterotopic ossification were used.

Results

The mean age of the patients was 46.6 ± 9.3 years, and the mean follow-up period was 11.83 ± 2.9 years. The mean HHS was 90.3 ± 12.8 for final follow-up. The mean WBC value was 8.2 109/L, mean CRP value was 6.3 mg/L, mean chromium value was 4.9 µg/L, and mean cobalt value was 1.8 µg/L. Inclination changing 0.2°(p = 0.788), stem shaft angle changing 0.7°(p = 0.424), and neck-to-prosthesis ratio changing 0.01°(p = 0.075). No pseudo-tumours were detected in any patients in USG examination.

Conclusion

HRA provides long-term implant survival and excellent clinical outcomes for end-stage ONFH patients with low complication rates.

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Authors and Affiliations

  1. Orthopedics and Traumatology Department, Ankara City Hospital, Ankara, Turkey

    Serhat Akçaalan & Mehmet Can Kengil

  2. Orthopedics and Traumatology Department, Ankara Yıldırım Beyazıt University, Ankara, Turkey

    Ceyhun Çağlar & Mahmut Uğurlu

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  1. Serhat Akçaalan
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  2. Mehmet Can Kengil
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  3. Ceyhun Çağlar
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  4. Mahmut Uğurlu
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Contributions

SA and MCK developed the theoretical formalism, performed the analytic calculations, and performed the numerical simulations. Both SA and CÇ authors contributed to the final version of the manuscript. MU supervised the project.

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Correspondence to Serhat Akçaalan.

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Akçaalan, S., Kengil, M.C., Çağlar, C. et al. Is there still an indication for the Birmingham Hip Resurfacing in femoral head osteonecrosis?. International Orthopaedics (SICOT) 48, 1157–1163 (2024). https://doi.org/10.1007/s00264-023-06070-8

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