Acta Orthop Traumatol Turc
Midterm results of total hip replacement in osteonecrosis of the hip joint
Abstract
Objectives: We evaluated the midterm results of total hip arthroplasty (THA) for femoral neck osteonecrosis.
Methods: The study included 59 patients (23 females, 36 males; mean age 45.6 years; range 24 to 66 years) who underwent THA in 72 hips. Osteonecrosis was secondary to fracture in the femoral neck in 11 hips (15.3%), was associated with steroid use in 23 hips (31.9%), and was idiopathic in 38 hips (52.8%). Functional evaluations were made with the hip scoring system of D’Aubigne and Postel. Bone-implant relations were assessed radiographically using the Gruen’s seven zones in the femur and Charnley’s three zones in the acetabulum. The mean follow-up was 4.1 years (range 2 to 7 years).
Results: The mean D’Aubigne-Postel hip score was 11.8 (range 7 to 16), with good or excellent results in all hips. While no significant difference was found between cementless and hybrid systems (p>0.05), the mean hip score was significantly higher with press-fit acetabular systems compared to expansion cups (p0.05): etiology, metal-on-metal or metal-on-polyethylene surfaces, and development of stress shielding in the proximal femur or of varus-valgus angulation in the femoral stem. However, the results were significantly less favorable in cases in which complications arose (p
Methods: The study included 59 patients (23 females, 36 males; mean age 45.6 years; range 24 to 66 years) who underwent THA in 72 hips. Osteonecrosis was secondary to fracture in the femoral neck in 11 hips (15.3%), was associated with steroid use in 23 hips (31.9%), and was idiopathic in 38 hips (52.8%). Functional evaluations were made with the hip scoring system of D’Aubigne and Postel. Bone-implant relations were assessed radiographically using the Gruen’s seven zones in the femur and Charnley’s three zones in the acetabulum. The mean follow-up was 4.1 years (range 2 to 7 years).
Results: The mean D’Aubigne-Postel hip score was 11.8 (range 7 to 16), with good or excellent results in all hips. While no significant difference was found between cementless and hybrid systems (p>0.05), the mean hip score was significantly higher with press-fit acetabular systems compared to expansion cups (p0.05): etiology, metal-on-metal or metal-on-polyethylene surfaces, and development of stress shielding in the proximal femur or of varus-valgus angulation in the femoral stem. However, the results were significantly less favorable in cases in which complications arose (p
References
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