Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
J Artif Organs. 2024 Sep;27(3):277-283. doi: 10.1007/s10047-023-01417-9. Epub 2023 Sep 14.
Hemi-resurfacing arthroplasty (Hemi) and metal-on-metal hip resurfacing arthroplasty (HR) were proposed as alternatives to conventional total hip arthroplasty (THA) for patients with osteonecrosis of the femoral head (ONFH). Long-term results were evaluated.
Twenty-three hips with ONFH were treated, using Hemi in 12 and HR in 11. Mean follow-up was 15 years in the Hemi group and 10 years in the HR group. Long-term outcomes were reviewed retrospectively.
In the Hemi group, 8 hips showed acetabular protrusion and were revised to THA. One of the 8 hips showed femoral loosening. In the HR group, pseudotumor was detected in 4 hips (36%), and 1 hip was revised due to symptomatic pseudotumor. No evidence of any femoral or acetabular loosening was seen in the HR group. Ten-year survival rates were 64.2% and 90.9% in the Hemi and HR groups, respectively. Survival rate in the Hemi group dropped to 22.9% at 15 years.
Long-term results of Hemi for patients with ONFH were very poor, and Hemi should not continue to be used. Although HR had a concern of pseudotumor, it could offer attractive indications for 10 years.
半髋关节成形术（Hemi）和金属对金属髋关节表面置换术（HR）被提议作为股骨头坏死（ONFH）患者的传统全髋关节置换术（THA）的替代方案。评估长期结果。
对 23 例 ONFH 患者进行治疗，Hemi 组 12 例，HR 组 11 例。Hemi 组平均随访 15 年，HR 组平均随访 10 年。回顾性回顾长期结果。
在 Hemi 组中，8 髋出现髋臼突出并改为 THA。8 髋中有 1 髋出现股骨松动。在 HR 组中，4 髋（36%）出现假瘤，1 髋因症状性假瘤而修订。HR 组未见任何股骨或髋臼松动的证据。Hemi 和 HR 组的 10 年生存率分别为 64.2%和 90.9%。Hemi 组 15 年的生存率降至 22.9%。
对于 ONFH 患者，Hemi 的长期结果非常差，不应继续使用。虽然 HR 存在假瘤的担忧，但它可以提供 10 年的诱人适应症。
