Hip hemiarthroplasty after displaced femoral neck fracture: a survivorship analysis.

The standard of care for displaced femoral neck fractures is not clear. We reviewed all patients 65 years or older with displaced femoral neck fracture who underwent hip hemiarthroplasty at our institution between 1997 and 2006. Women accounted for 70% of the patients.

Effect of changing indications and techniques on total hip resurfacing.

Recently, improved metal-on-metal bearing technology has led to the reemergence of resurfacing as a reasonable option for total hip arthroplasty. During the course of a prospective multicenter FDA-IDE evaluation of metal-on-metal total hip resurfacings, we modified our indications and emphasized surgical technique where the femoral surface area was small due to femoral cysts and small component size. We assessed the influence of these changes on complication rates in the first cohort of 292 patients and the second of 724, and then compared these outcomes in the second cohort with historical reports of resurfacing.

Resurfacing arthroplasty in osteonecrosis of the hip.

Approximately 10% of the total hip replacements performed in the United States are for osteonecrosis. Resurfacing arthroplasty has received renewed interest, with several new designs being implanted worldwide. Proponents of resurfacing arthroplasty describe the advantages of bone conservation, preservation of joint mechanics, more physiologic loading of the bone, lower incidence of perioperative complications, and easier conversion to a secondary procedure if failure occurs.

Impact of implant design on femoral head hemiresurfacing arthroplasty.

Two consecutive series of cemented femoral hemiresurfacing arthroplasty for patients with Ficat Stage III and early Stage IV osteonecrosis of the femoral head were studied to identify the impact of design on the clinical and radiographic results. Group I (30 patients, 33 hips) components had a cobalt chrome shell with a tapered inner dimension, no stem, and sizes in 2-mm increments. Group II (37 patients, 51 hips) components differed by adding a proportional stem, increased spherical coverage, and sizes in 1-mm increments.