Role of Metal-on-Metal Resurfacing in the Treatment of Late Stage Osteonecrosis

Many patients with osteonecrosis of the femoral head present or end up with late-stage disease. There are few options beyond standard total hip arthroplasty available for these patients. Metal-on-metal resurfacing arthroplasty offers a viable alternative for some of these patients. The early- and midterm results appear to be similar to standard hip arthroplasty. This treatment method may be especially efficacious in certain patient populations such as sickle cell anemia, systemic lupus erythematosus, for whom the results of standard total hip arthroplasties have not been optimal. Studies evaluating resurfacing over longer periods of time are being performed and may provide further insights into how femoral failures can best be reduced.

Keywords: resurfacing, metal-on-metal, osteonecrosis, avascular necrosis, total hip, surface replacement