Surface arthroplasty of the hip: A review and current indications

Surface arthroplasty of the hip has been reintroduced to maximize bone stock preservation and minimize the morbidity of revision surgery in the young and active adult with hip disease. Hemi-resurfacing arthroplasty has now a well-defined role in the very young patient with osteonecrosis of the hip in the presence of collapse and minimal acetabular cartilage damage. In patients with advanced disease and a relatively young age, metal-on-metal surface arthroplasty offers a conservative prosthetic solution with predictable pain relief. In addition, proper patient selection with the use of the Surface Arthroplasty Risk Index and careful surgical technique have been shown to impact clinical outcome. Early results have shown a significant decrease in short-term failures and equal clinical functional results in total hip replacement for this patient age group.