Long-term follow-up of a total articular resurfacing arthroplasty and a cup arthroplasty in Gaucher's disease.

Patients with Gaucher's disease, a well-described lipid storage disorder with many systemic manifestations, often present to the orthopaedic surgeon with osteonecrosis of the femoral head. This can be a difficult orthopaedic problem because of the patient's young age at presentation and abnormal bone stock. Review of the literature leaves uncertainty as to the ideal treatment of femoral-head avascular necrosis in this disease. This article reports the long-term results of a cup arthroplasty and a total articular resurfacing arthroplasty procedure for bilateral hip involvement. In light of the less-than-satisfactory results of total hip arthroplasty for young patients with Gaucher's disease, resurfacing arthroplasty may warrant more serious consideration. For the older patient with Gaucher's disease, total hip arthroplasty may be preferable.