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KMID : 0386720100220020129
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Journal of the Korean Hip Society
2010 Volume.22 No. 2 p.129 ~ p.136
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Cementless Total Hip Arthroplasty for Osteonecrosis of the Femoral Head -A Follow-up Study for 10+ Years-
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Chung Jong-won
Park Sang-Won
Han Seung-Beom
Park Jong-Hoon
Kim Ho-Joong
Lee Won-Suck
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Abstract
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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.
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KEYWORD
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Femoral head, Osteonecrosis, Cementless femoral stem, Cementless acetabular cup, Primary THRA
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