Hip resurfacing arthroplasty is relatively contraindicated in which one of the following patients?

• A A 45-year-old male manual labourer with osteoarthritis and good bone stock
• B A 40-year-old man with post-traumatic arthritis and preserved femoral head size
• C A 52-year-old woman with osteoporotic proximal femoral bone and a small femoral head ✓
• D A 48-year-old man with avascular necrosis involving less than 50% of the femoral head

Explanation

Resurfacing preserves femoral bone but requires adequate bone stock; osteoporotic bone risks intraoperative notching and postoperative femoral neck fracture, the classic failure mode. Small femoral heads are also unfavourable because they carry higher revision rates and, with metal bearings, higher blood metal ion exposure. The ideal candidate is a young man with good bone stock and a large head, as in options A, B and D.

Reference: Miller's Review of Orthopaedics, 8th ed.

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Written and medically reviewed by the StethoPrep medical team.