MEDIUM-TERM RESULTS OF PARTIAL HIP ARTHROPLASTY

Alexandros Tzaveas and Richard Villar
The Richard Villar Practice, Wellington Hospital, London, UK
Isolated osteochondral lesions (OCLs) of the femoral head remain a difficult problem for surgeons in trying to balance a minimally invasive technique against a greater benefit for the patient. We present our experience of the Hemicap partial resurfacing arthroplasty system in 12 patients. In 10 of them the lesions were seen arthroscopically. Seven of them had coexisting grade 1 chondral lesions. In three patients the OCL was surrounded by normal cartilage, and in two patients the lesion was caused by avascular necrosis of the femoral head. The mean age of the patients was 41 years (range, 30 to 63) and the mean follow-up 27 months (range, 9 to 48).
Five patients eventually underwent resurfacing arthroplasty or total hip arthroplasty at a mean of 17 months (range, 12 to 24) because of persistent pain. In three patients a further hip arthroscopy was required at a mean of 36 months (range, 24 to 48). In four patients no further surgery was required, and they have been followed up for a mean of 32.7 months (range, 9 to 43). At all the revision procedures the implants appeared stable and intact.
Partial resurfacing arthroplasty appears to show a tendency to early failure, particularly in patients with osteoarthritis, and more favourable results in patients with avascular necrosis of the femoral head, and surgeons should adopt a cautious attitude towards this type of arthroplasty.