https://doi.org/10.1177/1120700019858728 HIP International 1–9 © The Author(s) 2019 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/1120700019858728 journals.sagepub.com/home/hpi HIP HIP International Introduction Childhood diseases involving the proximal femoral epi- physis often result in anatomic abnormalities that lead to hip arthritis later in life. Cartilage wear occurs because of alterations in hip mechanics, defects of the articular sur- face, and femoroacetabular impingement. The early onset of disease may cause end-stage arthritis at a relatively young age, necessitating total hip arthroplasty (THA). The young age of these patients makes hip resurfacing arthroplasty (HRA) an attractive option because of the ability to return to high impact activities, and to preserve femoral bone. 1–4 HRA is an alternative to traditional THA, best suited for male patients younger than 50–65 years of age, with good bone quality and primary osteoarthritis. 5–10 However, in general, it is used for patients with relatively normal proximal femoral geometry in order to maximise Hip resurfacing arthroplasty for end-stage arthritis caused by childhood hip disease Edwin P Su 1 , Rachelle Morgenstern 1 , Imraan Khan 1 , Melissa D Gaillard 2 and Thomas P Gross 2 Abstract Introduction: Patients with hip arthritis due to Legg-Calvé-Perthes (LCP) and slipped capital femoral epiphysis (SCFE) pose altered femoral anatomy, making hip resurfacing arthroplasty (HRA) technically complicated. We examined implant survival and clinical symptoms in patients with a history of LCP or SCPE who underwent HRA for end-stage osteoarthritis. Methods: Data was collected for patients who underwent HRA for osteoarthritis due to LCP (n = 59) or SCFE (n = 32). Harris Hip Scores (HHS), UCLA activity scores, and radiographs were evaluated pre and postoperatively. Wilcoxon Signed-Rank Tests and Kaplan-Meier Survivorship curves were used to analyse data. Results: Survivorship for freedom from revision or clinical failure was 93.55(95% CI, 78.47–98.18) at 5.79 years, up until the most recent follow-up of 11.23 years. There were 3 failures: 1 LCP due to instability at 2.4 years, 1 SCFE due to femoral neck fracture at 1 month, and another SCFE due to unexplained pain at 5.8 years. Five patients, 1 LCP and 4 SCFE, had retained hardware prior to surgery; 4 had their hardware removed during surgery. Postoperatively HHS and UCLA activity scores increased (p < 0.0001, for both measures). Leg-length discrepancy improved preoperatively from 7.9 (0.0–32) mm to 0.65 (0.0–10) mm postoperatively (p < 0.0001). Follow-up radiographs of all non-failure HRA patients revealed implants to be in good alignment with no indication of loosening. Conclusion: Although HRA in SCFE and LCP patients increases technical difficulties, findings demonstrate excellent implant survival, no intraoperative complications, and improvements in leg-length discrepancies and clinical functional outcomes. Keywords Acetabular dysplasia, hip resurfacing arthroplasty, Legg-Calvé-Perthes, proximal femoral anatomy, slipped capital femoral epiphysis, total hip arthroplasty Date received: 20 July 2018; accepted: 11 February 2019 1 Department of Orthopaedic Surgery, Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, New York, NY, USA 2 Midlands Orthopaedics, Columbia, SC, USA Corresponding author: Rachelle Morgenstern, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA. Email: morgensternr@hss.edu 858728HPI 0 0 10.1177/1120700019858728HIP InternationalSu et al. research-article 2019 Original Research Article