Knowing the cause of resurfacing failure can ensure successful conversion to THR

The shell can be retained in cases involving femoral neck fracture, femoral loosening or impingement.

Orthopedics Today—March 3, 2010

Although hip resurfacing is becoming a popular option for surgeons treating young and active patients, the procedure carries a higher short-term failure rate than total hip arthroplasty, according to a New York surgeon.

At the 26th Annual Current Concepts in Joint Replacement Winter Meeting, Edwin P. Su, MD, described how surgeons can obtain good outcomes when converting a failed hip resurfacing to a total hip replacement (THR).

Causes of failure

“The cause of failure must be carefully assessed prior to the conversion surgery in order to ensure an optimal THR outcome,” Su said. He noted that femoral neck fracture is the primary cause of short-term failure in resurfacing procedures. He theorized that the rate of these fractures could be reduced with improved surgical techniques, careful patient selection and preoperative evaluation of bone quality. Inadequate acetabular fixation or the so-called “slipped cup” is another cause of early failure, which may also be related to surgical technique.

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