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Uncemented surface replacement for osteonecrosis of the femoral head.

From 1973 to 1982, we performed 40 uncemented surface arthroplasties using 27 Thomine and 13 Gerard cups in 32 patients with osteonecrosis of the femoral head (Ficat Stages 3 and 4). The median follow-up was 8 (3-12) years, with a median age at operation of 35 (19-60) years. Walking ability and mobility were improved, but relief from pain was the most significant improvement. In 28 of the 40 hips the result was excellent or good according to the scoring system of Merle d'Aubigné. The clinical outcome was not influenced by varus angulation, axial resorption, or acetabular protrusion of the cup. As compared with other methods of treatment for osteonecrosis with loss of sphericity of the femoral head, we conclude that the cup arthroplasty is a good choice of treatment in the young patient.