Article
Outcome of a mini-resurfacing implant as an alternative treatment for local cartilage defects of the femoral head
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Published: | October 23, 2017 |
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Outline
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Objectives: Local cartilage and bony defects, which are too large for joint preserving cartilage treatment like microfracturing or AMIC, are difficult to treat. In these cases the defect is often limited to the femoral head. If the patient is young and does not show severe signs of osteoarthritis, the implantation of a total hip arthroplasty seems to replace more than maybe necessary. The implantation of a mini-resurfacing implant (Hemicap®, 2med, Hamburg, Germany) may be a possible alternative treatment for these patients. This partial replacement fills the defect and restores a smooth and continuous articular surface. The aim of this study was to determine short- to midterm results of the treatment of local cartilage defects of the femoral head using the Hemicap®.
Methods: Since 04/2011 16 patients with osteonecrosis of the femoral head greater ARCO stage II or local femoral cartilage lesions (< 35 mm) were treated with the implantation of the Hemicap® implant. A clinical and radiological follow-up was conducted using visual analogue pain scale, the Harris-Hip-Score and the UCLA-activity score.
Results and Conclusion: The clinical results showed a significant improvement of the function and pain of the hip according to the Harris Hip Score from 56 (±14) preoperative to 77 (±15) postoperative 23 months after implantation of the Hemicap® . In the meantime in four patients the Hemicap® had to be converted to a total hip arthroplasty due to loosening, progredience of the osteonecrosis or degeneration of the acetabulum.
The implantation of the mini-resurfacing implant Hemicap® is an alternative treatment for local cartilage defects of the femoral head to postponed the implantation of a total hip arthroplasty. However, the patient selection for this treatment (limited size of the defect, only femoral defect, no degeneration of the acetabulum) is of great importance.