Patient selection and surgical technique for surface arthroplasty of the hip

Factors such as patient selection, surgical technique, and durable fixation of the components are critical in surface arthroplasty of the hip. The Surface Arthroplasty Risk Index helps determine the risk of failure, with an index score <= 3 having a 97% survivorship at 4 years. Because surface arthroplasty of the hip is conservative in nature and has the goal to closely reproduce the normal anatomy of the proximal femur, surgeons performing this procedure need to take into consideration the underlying pathology that led to the degenerative changes. Consequently, choice of surgical approach and positioning of the implants may have a greater impact on implant survivorship and patient function than in standard hip replacement. This article presents case illustrations of different hip pathologies treated by surface arthroplasty of the hip.