METAL-ON-METAL HIP RESURFACING ARTHROPLASTY USING THE DIRECTLATERAL APPROACH. FIRST RESULTS AND LITERATURE REVIEW
Abstract
BACKGROUND The rebirth of metal-on-metal hip resurfacing can be attributed to the advance of orthopaedic implants manufacturing as is to the evolution of the surgical technique. It has mostcommonly been done through the posterior surgical approach, but with risk of developingavascular necrosis of the femoral head where the prosthesis is embedded into. The articledescribes our experience with use of the direct lateral surgical approach.Patients and The Orthopaedic Hospital Valdoltra prosthetic registry was searched for patients whomethods have had hip arthroplasties done. 25 such patients were found, 16 among them have been followed for at least a year. All 16 patients (18 operated hips) were males with primary hiposteoarthritis and mean age of 49 years. All but one were operated with direct lateralsurgical approach, had the same type of prosthesis implanted and followed the same rehabilitation protocol. RESULTS All patients were evaluated preoperatively as well as on follow-up examinations. A rise ofHarris Hip Score (HSS) from 42 preoperatively to 98 at 1 year postoperatively was recorded. We had no major complications, except for slight acetabular component malpositionin terms of decreased inclination in 1 patient and appearance of a Brooker Grade 1 or 2heterotopic ossifications in 4 patients on postoperative X-rays. CONCLUSIONS Metal-on-metal hip resurfacing gained considerable reupraisal with new generations ofprosthesis design. It provides considerable advantage compared to conventional total hiparthroplasty but is indicated only with a selected patient group and is technically moredifficult. The use of direct lateral surgical approach has proved to be safe and reliablecompared to the already proven posterior approachDownloads
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