The unipolar ASR : Viable option in unsalvageable femoral head conditions in the young patient


<b>Background: </b> The management of unsalvageable femoral head conditions in the young patient has remained an unresolved dilemma. Articular surface replacement of the hip has recently made some headway in terms of providing near-normal hip joint mechanics and function. However, this surgery has been limited to early stages of arthritis only with reasonable maintenance of head-neck congruity and morphology. Femoral neck fractures, osteonecrosis with large segment collapse, advanced arthritis with femoral incongruity, etc are traditional contraindications to the resurfacing technique. <b> Methods: </b> We present here a report on our series of 20 cases of unsalvageable femoral heads in young patients (age range, 27 to 52yrs), over a twelve month period (Aug 2004 to Jul 2005), treated with the unipolar ASR prosthesis. Fifteen patients (two had bilateral hip pathology) had primary or secondary arthritis (degenerative, post-traumatic, ankylosing spondylitis and post-avascular necrosis) while three had old operated femoral neck fractures. All patients underwent hip replacement surgery using the Unipolar ASR prosthesis. <b> Results: </b> Clinical and radiological results at 6-month follow up have been very encouraging and warrant further study. At an average of 4 months post-operatively, patients were able to squat, sit on the ground and perform light sporting activities. <b> Conclusions: </b> The Unipolar ASR prosthesis is an extension of the articular resurfacing technique employing similar principles (large size bearings, metal-on-metal interfaces), and has incorporated the advantages of the uncemented technique. We propose that this technique be more frequently used so as to brighten the prognosis of the young active patient with unsalvageable hip conditions, especially in the Asian scenario

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