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KMID : 0361620100450040273
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Journal of the Korean Orthopaedic Association
2010 Volume.45 No. 4 p.273 ~ p.280
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Bipolar Hip Arthroplasty vs. Total Hip Arthroplasty for Osteonecrosis of the Femoral Head
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Kim Sung-Soo
Sohn Sung-Keun
Kim Hyeon-Jun
Sun Sang-Kyu
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Abstract
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Purpose: To retrospectively compare surgical outcomes between bipolar hip arthroplasty and total hip arthroplasty in patients with osteonecrosis of the femoral head.
Materials and Methods: Between April 2000 and July 2004, we reviewed 51 cases with Ficat stage III osteonecrosis of the femoral head that underwent bipolar hip arthroplasty (BHA) and 52 cases that received total hip arthroplasty (THA). The minimum follow-up period was 5 years. All prostheses used in the current study had cementless stem and metal-on-polyethylene bearings. We analyzed clinical and radiological results, reoperation, operation time and blood loss the BHA group (mean follow-up of 81 months) and the THA group (82 months).
Results: There were no statistically differences between the two groups in preoperative and postoperative mean Harris hip scores. There were no significant differences between the two groups in clinical results, including persistent inguinal pain and radiologic changes around the acetabular cup and femoral stem (p>0.05). Three cases (5.9%) in the BHA group and 5 cases (7.7%) in the THA group underwent revisions. The mean operation time was 96 minutes in the BHA group and 118 minutes in the THA group. Mean blood loss was 625 cc in the BHA group, and 784 cc in the THA group. The differences between the two groups in mean operation time and blood loss were significant (p<0.05).
Conclusion: The BHA group, which used cementless stem and metal-on-polyethylene bearings for Ficat stage III osteonecrosis of the femoral head, showed no significant differences from the THA group in postoperative radiologic change, clinical evaluation, and reoperation during 81 months of mean follow-up.
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KEYWORD
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osteonecrosis, femoral head, bipolar hip arthroplasty, total hip arthroplasty
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