1. HEMIRESURFACING M. E. Cabanela, M.D. Professor of Orthopedic Surgery Mayo Clinic College of Medicine Rochester, Minn. M. E. Cabanela, M.D. Professor of Orthopedic Surgery Mayo Clinic College of Medicine Rochester, Minn.

2. Surface hemiarthroplasty fixed with cement Surface hemiarthroplasty fixed with cement Best indication: Stage III AVN with minimal acetabular damage Best indication: Stage III AVN with minimal acetabular damage HEMIRESURFACING

20. Adili A, Trousdale RT: Femoral head resurfacing for treatment of osteonecrosis in the young patient. CORR 417:93-101, 2003. Adili A, Trousdale RT: Femoral head resurfacing for treatment of osteonecrosis in the young patient. CORR 417:93-101, 2003.

21. HEMIRESURFACING Demographics 2-1997 - 4-2000 29 conseiccutive pts 18 m/10 f 31.6 yrs (12-48) Hip pain 23 mos (6-96 mos) Etiology: steroid 16 ETOH 2 ETOH 2 other 5 other 5 None 4 None 4 F-up 34 mos (24-63)

22. HEMIRESURFACING Results HHS 48.1 - 79.3 HHS 48.1 - 79.3 Survivorship 93.5% @ 1 yr Survivorship 93.5% @ 1 yr 75.9% @ 3 yrs 75.9% @ 3 yrs Revision to THA 8 hips (27.6%) Revision to THA 8 hips (27.6%) Pain in groin 4 hips (14%) Pain in groin 4 hips (14%) Satisfactory pain relief 62.5% @ 3 yrs Satisfactory pain relief 62.5% @ 3 yrs

23. HEMIRESURFACING Literature Review Hungerford 91% survival @ 5 yrs 71% @ 10 yrs Hungerford 91% survival @ 5 yrs 71% @ 10 yrs Beaulé 79% revision free @ 5 yrs 59% @ 10 yrs Beaulé 79% revision free @ 5 yrs 59% @ 10 yrs Nelson 82% success @ 6.2 yrs Nelson 82% success @ 6.2 yrs Mont 90% survival @ 7 yrs Mont 90% survival @ 7 yrs

24. HEMIRESURFACING Advantages Minimal bone resection Minimal bone resection Revision to THA not compromised Revision to THA not compromised No EHDP No EHDP Can delay THA Can delay THA Can be satisfactory interim solution Can be satisfactory interim solution

25. HEMIRESURFACING Conclusions Unpredictable pain relief Unpredictable pain relief Acceptable alternative in young pt with ON and preserved acetabulum Acceptable alternative in young pt with ON and preserved acetabulum