Browse > Article

Cementless Total Hip Arthroplasty for Osteonecrosis of the Femoral Head- A Follow-up Study for 10+ Years -  

Chung, Jong-Won (Department of Orthopedic Surgery, College of Medicine, Korea University)
Park, Sang-Won (Department of Orthopedic Surgery, College of Medicine, Korea University)
Han, Seung-Beom (Department of Orthopedic Surgery, College of Medicine, Korea University)
Park, Jong-Hoon (Department of Orthopedic Surgery, College of Medicine, Korea University)
Kim, Ho-Jung (Department of Orthopedic Surgery, College of Medicine, Korea University)
Lee, Won-Suck (Department of Orthopedic Surgery, College of Medicine, Korea University)
Publication Information
Hip & pelvis / v.22, no.2, 2010 , pp. 129-136 More about this Journal
Abstract
Purpose: The aim of this study was to assess the outcome of cementless total hip arthroplasty (THA) in cases of osteonecrosis of the femoral head. Materials and Methods: We studied long-term outcomes for 54 patients (72 hips). Mean duration of follow-up was 13.5 years. Clinical outcomes were evaluated by the Harris Hip Score. Radiographic evaluation from the preoperative and follow-up periods included assessment of the fixation of the femoral and acetabular components, polyethylene wear, osteolysis, and radiolucent line. Results: The mean Harris Hip Score improved from a preoperative value of 51.9 points to 89.4 at final follow-up. Regarding the femoral components, there was radiographic evidence of stable bony ingrowth in 69 hips, stable fibrous ingrowth in 2 hips and unstable fixation in 1 hip. There was a radiolucent line of less than 1 mm in 7 hips, and femoral osteolysis in 27 hips. Regarding the acetabular components, there was radiographic evidence of stable fixation in 68 hips, unstable fixation in 4 hips, and osteolysis in 39 hips. There was a significant correlation between (i) failure of components and (ii) femoral osteolysis, acetabular osteolysis, polyethylene thickness, linear wear rate per year, or total linear wear. Conclusion: The findings of this study show favorable long term results, both clinical and radiographic, using cementless total hip replacement arthroplasties. However, the revision rates for the Harris-Galante acetabular components were high. Wear of the load? weight? bearing surface continues to limit the long-term success rate of THA, and improved design of the acetabular components should be considered.
Keywords
Femoral head; Osteonecrosis; Cementless femoral stem; Cementless acetabular cup; Primary THRA;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Ortiguera CJ, Pulliam IT, Cabanela ME. Total hip arthroplasty for osteonecrosis: matched-pair analysis of 188 hips with long-term follow-up. J Arthroplasty. 1999;14:21-8.   DOI   ScienceOn
2 Ritter MA, Meding JB. A comparison of osteonecrosis and osteoarthritis patients following total hip arthroplasty. A long-term follow-up study. Clin Orthop Relat Res. 1986;206:139-46.
3 Saito S, Saito M, Nishina T, Ohzono K, Ono K. Long-term results of total hip arthroplasty for osteonecrosis of the femoral head. A comparison with osteoarthritis. Clin Orthop Relat Res. 1989;244:198-207.
4 Salvati EA, Cornell CN. Long-term follow-up of total hip replacement in patients with avascular necrosis. Instr Course Lect. 1988;37:67-73.
5 Madey SM, Callaghan JJ, Olejniczak JP, Goetz DD, Johnston RC. Charnley total hip arthroplasty with use of improved techniques of cementing. The results after a minimum of fifteen years of follow-up. J Bone Joint Surg Am. 1997;79:53-64.   DOI   ScienceOn
6 Mulroy RD Jr, Harris WH. The effect of improved cementing techniques on component loosening in total hip replacement. An 11-year radiographic review. J Bone Joint Surg Br. 1990;72:757-60.
7 Mulroy WF, Estok DM, Harris WH. Total hip arthroplasty with use of so-called second-generation cementing techniques. A fifteen-year-average follow-up study. J Bone Joint Surg Am. 1995;77:1845-52.
8 Piston RW, Engh CA, De Carvalho PI, Suthers K. Osteonecrosis of the femoral head treated with total hip arthroplasty without cement. J Bone Joint Surg Am. 1994;76:202-14.
9 Xenakis TA, Gelalis J, Koukoubis TA, Zaharis KC, Soucacos PN. Cementless hip arthroplasty in the treatment of patients with femoral head necrosis. Clin Orthop Relat Res. 2001;386:93-9.   DOI   ScienceOn
10 Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51:737-55.
11 Engh CA, Bobyn JD, Glassman AH. Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg Br. 1987;69:45-55.
12 Engh CA, Massin P, Suthers KE. Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res. 1990;257: 107-28.
13 Sakalkale DP, Eng K, Hozack WJ, Rothman RH. Minimum 10-year results of a tapered cementless hip replacement. Clin Orthop Relat Res. 1999;362:138-44.
14 Martell JM, Pierson RH 3rd, Jacobs JJ, Rosenberg AG, Maley M, Galante JO. Primary total hip reconstruction with a titanium fiber-coated prosthesis inserted without cement. J Bone Joint Surg Am. 1993;75:554-71.
15 Gruen TA, McNeice GM, Amstutz HC."Modes of failure"of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res. 1979;141:17-27.
16 DeLee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res. 1976;121:20-32.
17 Livermore J, Ilstrup D, Morrey B. Effect of femoral head size on wear of the polyethylene acetabular component. J Bone Joint Surg Am. 1990;72:518-28.
18 Capello WN. Fit the patient to the prosthesis. An argument against the routine use of custom hip implants. Clin Orthop Relat Res. 1989;249:56-9.
19 Chiu KH, Shen WY, Ko CK, Chan KM. Osteonecrosis of the femoral head treated with cementless total hip arthroplasty. A comparison with other diagnoses. J Arthroplasty. 1997;12:683-8.   DOI   ScienceOn
20 Taylor AH, Shannon M, Whitehouse SL, Lee MB, Learmonth ID. Harris Galante cementless acetabular replacement in avascular necrosis. J Bone Joint Surg Br. 2001;83:177-82.   DOI   ScienceOn
21 Berger RA, Jacobs JJ, Quigley LR, Rosenberg AG, Galante JO. Primary cementless acetabular reconstruction in patients younger than 50 years old. 7- to 11-year results. Clin Orthop Relat Res. 1997;344:216-26.
22 Hartley WT, McAuley JP, Culpepper WJ, Engh CA Jr, Engh CA Sr. Osteonecrosis of the femoral head treated with cementless total hip arthroplasty. J Bone Joint Surg Am. 2000;82-A:1408-13.
23 Baek JR, Park SW, Oh KJ, Chung JW, Cho HJ. Primary total hip arthroplasty using Multilock femoral stem in nontraumatic osteonecrosis of the femoral head-a comparison of under 50 and over 50 years old-. J Korean Hip Soc. 2005;17:107-11.
24 Mont MA, Seyler TM, Plate JF, Delanois RE, Parvizi J. Uncemented total hip arthroplasty in young adults with osteonecrosis of the femoral head: a comparative study. J Bone Joint Surg Am. 2006;88 Suppl:104-9.   DOI   ScienceOn
25 Stulberg BN, Singer R, Goldner J, Stulberg J. Uncemented total hip arthroplasty in osteonecrosis: a 2- to 10-year evaluation. Clin Orthop Relat Res. 1997;334:116-23.
26 Kim YH, Oh JH, Oh SH. Cementless total hip arthroplasty in patients with osteonecrosis of the femoral head. Clin Orthop Relat Res. 1995;320:73-84.
27 Yoo MC, Cho YJ, Kim KI, et al. Long term follow up study of cementless total hip arthroplasty for osteonecrosis of the femoral head: minimum 10-year follow up study. J Korean Hip Soc. 2004;16:1-9.
28 Sochart DH, Porter ML. The long-term results of Charnley low-friction arthroplasty in young patients who have congenital dislocation, degenerative osteoarthrosis, or rheumatoid arthritis. J Bone Joint Surg Am. 1997;79: 1599-617.
29 Maloney WJ, Peters P, Engh CA, Chandler H. Severe osteolysis of the pelvic in association with acetabular replacement without cement. J Bone Joint Surg Am. 1993;75:1627-35.
30 Schmalzried TP, Jasty M, Harris WH. Periprosthetic bone loss in total hip arthroplasty. Polyethylene wear debris and the concept of the effective joint space. J Bone Joint Surg Am. 1992;74:849-63.
31 Kim YH, Kim VE. Uncemented porous-coated anatomic total hip replacement. Results at six years in a consecutive series. J Bone Joint Surg Br. 1993;75:6-13.
32 Han CD, Lee WS, Choe WS, Cho JH. Cementless total hip arthroplasty for osteonecrosis in patients forty-five years old and less:minimum 5-year follow-up result. J Korean Hip Soc. 1999;11:134-41.