Hip resurfacing arthroplasty for end-stage arthritis caused by childhood hip disease.
INTRODUCTION
Patients with hip arthritis due to Legg-Calvé-Perthes (LCP) and slipped capital femoral epiphysis (SCFE) pose altered femoral anatomy, making hip resurfacing arthroplasty (HRA) technically complicated. We examined implant survival and clinical symptoms in patients with a history of LCP or SCPE who underwent HRA for end-stage osteoarthritis.


METHODS
Data was collected for patients who underwent HRA for osteoarthritis due to LCP (n = 59) or SCFE (n = 32). Harris Hip Scores (HHS), UCLA activity scores, and radiographs were evaluated pre and postoperatively. Wilcoxon Signed-Rank Tests and Kaplan-Meier Survivorship curves were used to analyse data.


RESULTS
Survivorship for freedom from revision or clinical failure was 93.55(95% CI, 78.47-98.18) at 5.79 years, up until the most recent follow-up of 11.23 years. There were 3 failures: 1 LCP due to instability at 2.4 years, 1 SCFE due to femoral neck fracture at 1 month, and another SCFE due to unexplained pain at 5.8 years. Five patients, 1 LCP and 4 SCFE, had retained hardware prior to surgery; 4 had their hardware removed during surgery. Postoperatively HHS and UCLA activity scores increased (p < 0.0001, for both measures). Leg-length discrepancy improved preoperatively from 7.9 (0.0-32) mm to 0.65 (0.0-10) mm postoperatively (p < 0.0001). Follow-up radiographs of all non-failure HRA patients revealed implants to be in good alignment with no indication of loosening.


CONCLUSION
Although HRA in SCFE and LCP patients increases technical difficulties, findings demonstrate excellent implant survival, no intraoperative complications, and improvements in leg-length discrepancies and clinical functional outcomes.
['Su|Edwin P|EP|', 'Morgenstern|Rachelle|R|', 'Khan|Imraan|I|', 'Gaillard|Melissa D|MD|', 'Gross|Thomas P|TP|']
D000293:Adolescent D000328:Adult D000368:Aged D019644:Arthroplasty, Replacement, Hip D002648:Child D005260:Female D005269:Femur D006621:Hip Joint D006801:Humans D053208:Kaplan-Meier Estimate D007873:Legg-Calve-Perthes Disease D008297:Male D008875:Middle Aged D015207:Osteoarthritis, Hip D011859:Radiography D012189:Retrospective Studies D060048:Slipped Capital Femoral Epiphyses D055815:Young Adult
hip resurfacing arthroplasty Legg-Calvé-Perthes slipped capital femoral epiphysis Acetabular dysplasia proximal femoral anatomy total hip arthroplasty