مرکز منطقه ای اطلاع رساني علوم و فناوري - Cementless total hip arthroplasty in patients with avascular necrosis of the femoral head

Latin Abstract :

Obj ectives : We assessed the results of cementless total hip arthroplasty in patients with late-stage avascular necrosis of the femoral head. Methods : Unilateral cementless total hip replacement was performed in 25 patients (19 males, 6 females; mean age 39.6 years; range 26 to 56 years) with avascular necrosis of the femoral head. A cementless acetabular cup with screws was used for the acetabulum with a cementless femoral component. Functional results were evaluated according to the Harris hip score. Radiographically, acetabular and femoral components were evaluated according to the crite¬ria of Lins et al. and Engh et al., respectively. Heterotopic ossification was assessed according to the criteria of Brooker et al. The mean follow-up was 63.9 months (range 48 to 94 months). Results : The mean Harris hip score increased from 41.5 (range 33 to 52) to 87.1 (range 74 to 96) after the treatment (p<0.001). No radiographic loosening was detected in 22 patients (88%). Radiolucent lines were observed in one acetabular and two femoral components, but no secondary interventions were performed as the patients were asympto¬matic. Heterotopic ossification was observed in 13 patients, which was grade 1 in eight patients, grade 2 in two patients, and grade 3 in three patients. Conclusion: In general, patients who undergo total hip arthroplasty for avascular necrosis of the femoral head are younger and more active compared to those with osteoarthritis, showing a high likelihood of future revision procedures. Our results favor cementless applications as a more appropriate alternative in this patient group.