Reports of long-term evaluation of the viability of the femoral head after a hemiresurfacing arthroplasty (HRA) are scarce. We report the case of a 41-year-old female with lupus and right HRA (performed 24 years previously for avascular necrosis) that was revised to a total hip arthroplasty for worsening right groin pain due to chondrolysis. We present a histologic evaluation of the resurfaced femoral head retrieved 24 years after HRA. To the authors' knowledge, this is the longest reported histologic follow-up of such a case. There was no evidence of fracture or inflammation and the underlying bone was viable. At 5-year follow-up after the revision, the patient is pain-free, fully functional, and walks without any assistive device.
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