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KMID : 0386720020140010001
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Journal of the Korean Hip Society
2002 Volume.14 No. 1 p.1 ~ p.8
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Uncemented Total Hip Arthroplasty Combined with Metal on Metal Articulation for Avascular Necrosis of the Femoral Head
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Kim Young-Ho
Park Ki-Chul
Kim HS
Choi Il-Yong
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Abstract
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Purpose : This study was undertaken in order to evaluate the results of total hip arthroplasty, using hydroxyapatite(HA) coated CLS stem and rough-blasted(RB) Wagner cup, combined with metal on metal articulation, in patients with avascular necrosis of the femoral head(Ficat and Arlet stage Ⅲ and Ⅳ)
Materials and Methods : From March 1994 to February 1998, fifty total hip arthroplasty procedures were performed on patients with avascular necrosis of the femoral head using HA coated CLS stem and rough-blasted(RB) Wagner cup, in combination with metal on metal articulation. We evaluated both clinical and radiographic parameters.
Results : The mean Harris hip score was 96.1, having improved from a preoperative value of 51.7. Radiographic findings demonstrated that endosteal bone formations around the stem were present in more than 90% of the cases in Gruen zones 1, 2, 6 and 7,as well as in 40 to 70% of the cases in zones 3, 4 and 5. Bone formation around the cup was present in 88%, 96% and 82% of the cases in zones 1, 2 and 3, respectively. There was no osteolysis around the stem, nor was there any measurable subsidence of the stem more than 2mm. The mean linear wear rate was too low to be measured. There was one revision of acetabular component in a patient with cup loosening due to severe osteonecrosis of the acetabulum.
Conclusion : Uncemented total hip arthroplasty with HA coated CLS stem and RB Wagner cup, combined with metal on metal articulation,in patients with osteonecrosis of the femoral head showed excellent clinical and radiographic results that were comparable to those in patients with other diagnoses. Hip surgeons should bear in mind that severe osteonecrosis of the acetabulum can, on rare occasions, be combined with common/usual osteonecrosis of the femoral head.
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KEYWORD
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Femoral head, Avascular necrosis, Uncemented total hip arthroplasty
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