CORR Insights^®: Frequent Femoral Neck Osteolysis With Birmingham Mid-head Resection Resurfacing Arthroplasty in Young Patients

Excerpt

Mid-head resection resurfacing arthroplasty is considered a viable hip-preserving procedure that allows bone preservation to patients with an abnormal femoral head morphology and/or poor bone quality. These bone issues are generally found in younger patients (typically younger than 55 years of age) with hip osteonecrosis. The mid-head resection resurfacing may offer an alternative to conventional hip arthroplasty implants. However, there are only a few small studies with short-term followup (mean, 2 years to 3.5 years) using this particular implant that have shown high survivorship rates of 97% or greater [1‐3]. To the best of my knowledge, the study by Assad and colleagues presents the longest mean followup for these prostheses. The authors found an increased risk of osteolysis of the remaining femoral neck in these patients despite 100% survivorship at a mean 6-year followup (range, 3 years to 8 years). It appears that many of these hips (at least 16%) will ultimately fail due to osteolysis based on the findings of the present study. Patients who have not been followed closely should receive careful scrutiny. …