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  Global Journal of Surgery 2012, 3: 6
  Research Article
Improvements in the hip resurfacing surgical technique influence its failure pattern
  Matthias Krausea, Stefan Breera, Michael M Morlockb, Wolfgang Rütherc, Jozef Zustind  
a Institute of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Germany
b Biomechanics Section, TUHH Hamburg University of Technology, Germany
c Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Germany
d Institute of Pathology, University Medical Center Hamburg-Eppendorf, Germany

  The continual evolvement of the surgical technique and the training of surgeons before implementation of this arthroplasty method have been shown to improve the clinical outcomes for individual surgeons. We questioned whether the retrieved hips sent to our laboratory at the beginning and end of the Hamburg retrieval study reflected some of the changes in patient selection and surgical technique. Experimental: Morphological findings of a group of the first 50 consecutive retrieved THRA hips from the beginning of the Hamburg retrieval study were compared with the results of a group of the last 50 consecutive specimens from the end of the study. Results and Discussion: We observed changes in both the surgical technique (cemented stem) and failure patterns (fractures, extent of osteonecrosis, in situ time, interface hyperosteoidosis). While the improvements in the surgical technique positively influenced the formidable adverse effects of THRA (extent of osteonecrosis and prevalence of periprosthetic fractures) other biological reactions (excessive lymphocyte infiltration and hyperosteoidosis) that are most likely independent from the surgical technique were not less frequent. Conclusions: The improved surgical techniques of surgeons adapting hip resurfacing arthroplasty can positively influence the prevalence of early periprosthetic fractures after THRA associated with osteonecrosis.
  Hip resurfacing; Arthroplasty failure; Osteonecrosis; Fracture  

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