Treatment of osteonecrosis of femoral head in young patients by surface replacement of femoral head

Background: Osteonecrosis of hip is a pathological condition that affects usually young adults. Articular surface replacement (ASR) is considered to be a viable option in young patients. The study was done with the aim to analyse and to recommend the management of osteonecrosis of femoral head in young patients by surface replacement of femoral head as ideal procedure.Methods: The present study was conducted in 30 patients with osteonecrosis of the femoral head who attended to OPD at Santhiram Medical College and General Hospital, Nandyal, A.P during the period of April 2016 to September 2017. Articular surface replacement of the femoral head was the surgical procedure done in all the patients. The success of the treatment was analysed by Harris hip scoring.Results: Maximum number of patients (60%) was below 40 years of age. Male dominance (77%) was seen in the study. According to Ficat and Arlet classification 12 cases (40%) were under the category of stage II-B and 18 cases (60%) were of stage III. Postoperatively about 90% of patients had postoperative Harris hip score of >80 points. Surgery was succeeded in 10 hips of stage II-B and 15 hips in stage III. According to Harris hip scoring excellent results were obtained in 15 (50%), good in 12 (40%), fair in 2 (6.67%) and poor result 1 (3.3%) patient.Conclusion: The study concludes that the surface replacement is an anatomical hip arthroplasty with preservations of more than 70% of bone stock of femoral head and the ability of the patients to sit cross-legged and squat, which is the desire of the Indian population