Cementless Total Hip Arthroplasty in Patients With Osteonecrosis of the Femoral Head

Kim, Young-Hoo; Oh, Jeong-Hwan; Oh, Seung‐Hwan

doi:10.1097/00003086-199511000-00013

Cited by 43 publications

(40 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This contrasts with other studies in which high rates of osteolysis have been reported with cementless implants in young patients, even after a short to intermediate follow-up (Brinker et al 1994, Kim et al 1995, Kronick et al 1997.…”

Section: Discussioncontrasting

confidence: 94%

Cementless Spotorno tapered titanium stems

Aldinger

Thomsen

Mau

et al. 2003

Acta Orthopaedica Scandinavica

View full text Add to dashboard Cite

Section: Discussioncontrasting

confidence: 94%

Cementless Spotorno tapered titanium stems

Aldinger

Thomsen

Mau

et al. 2003

Acta Orthopaedica Scandinavica

View full text Add to dashboard Cite

“…The technical improvement of total hip arthroplasty (THA) seems to give hope of complete recovery from the degenerate diseases [6,7]. But for those young and middle-aged patients, it seems too early and patients may face the risk of more than one revision surgery and other complications [8,9]. Thus, the theory of joint preserving management has been widely accepted by orthopaedic clinicians.…”

Section: Introductionmentioning

confidence: 99%

Vascularised greater trochanter bone graft, combined free iliac flap and impaction bone grafting for osteonecrosis of the femoral head

Zeng

He²,

Feng³

et al. 2013

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Purpose To investigate the curative efficacy of osteonecrosis of the femoral head (ONFH) in a hip-preserving operative approach, by grafting a vascularized greater trochanter flap combined with a free iliac flap, in an attempt to seek an innovative approach for patients who suffered middle to late stage ONFH without total hip arthroplasty (THA) surgery. Method Our research included a total of 60 patients (66 hips) who accepted hip-preserving surgery by grafting a vascularized greater trochanter flap combined with a free iliac flap which was tightly filled by hammering because of ONFH (most were Association Research Circulation Osseous (ARCO) stage III patients) from January, 2006 to December, 2010. A Harris Hip Score was obtained during follow-ups, evaluating the clinical efficacy, X-rays were taken regularly for image assessing, and the SF-36 scale was used for estimating quality of life. Terminal observation time was considered when patients had symptom-dependant indications for performing another hip-preserving surgery or THA surgery. Results Fifty-eight patients (64 hips) were eventually contacted by telephone for an out-patient clinic return visit, with a mean follow-up time of 35.8 months (varied from 12 months to 60 months), but two patients lost contact for various reasons. The demographic data were as follows: there were 16 ARCO IIIA cases, 22 ARCO IIIB cases, and 26 ARCO IIIC cases, respectively. Postoperative X-rays revealed a well-repaired necrotic area of the femoral head and improvement of femoral-acetabulum coverage. The last follow-up mean Harris Hip Score was 86.56±7.38 (excellent results reached 87.50 %), which were greatly improved compared to 50.95±6.86 pre-operatively. Also the postoperative mean scores of all dimensions of the SF-36 scale were improved to some extent. Additionally the physical component summary (PSC) scores were enhanced from 42± 13 pre-operatively to 78±11, while the postoperative mental component summary (MCS) scores (76±11) largely increased in contrast to pre-operative scores (51±10), with both target indices having statistical significance (p=0.005, p=0.01), signifying hugely improvement of the quality of life of the patients. A correlation was found between Harris Hip Score and all dimensions of SF-36 scale (r=0.32-0.72), especially closely correlated with physical functioning (PF), role-physical (RP) and bodily pain (BP) in PCS aspect (r= 0.72, p < 0.01; r = 0.58, p < 0.01; r = 0.65, p < 0.01, respectively). Conclusion There is definite curative efficacy for the treatment of ONFH with an hip-preserving operative approach by grafting a vascularized greater trochanter flap combined with a free iliac flap which was tightly filled by hammering. This kind of operative approach reconstructs the biological stability of femoral head, which promotes repair of necrotic areas and indirectly preserves the femoral head of patients and a majority of hip function. It possesses vast clinical as well as practical significance, because the long-term efficacy can satisfy fundam...

show abstract

“…The risk of collapse of the femoral head depends on the extent and location of the lesion [1,24,36]. Despite improvements in techniques and materials in total hip arthroplasty (THA), survivorship in young patients is still suboptimal owing to the high rate of complications [7,18,20,33]. Although head-preserving surgeries such as core decompression [10,26] and vascularized and nonvascularized grafting [12,26,32,45] appear to delay the progression of collapse and subsequent arthritic changes, in these studies the indications vary in terms of etiologic factors, radiographic staging, or indications for surgery, and the survival rate of the femoral head decreases with increases in size and stage of the lesion [1,4,10,32].…”

Section: Introductionmentioning

confidence: 99%

Transtrochanteric Rotational Osteotomy for Nontraumatic Osteonecrosis of the Femoral Head in Young Adults

Biswal

Hazra

Yun

et al. 2009

Clin Orthop Relat Res

View full text Add to dashboard Cite

Transtrochanteric rotational osteotomy (TRO) is a controversial procedure with reported inconsistent results. We reviewed 50 patients (60 hips) who underwent this procedure for extensive osteonecrosis of the femoral head, focusing on varization to determine its effectiveness as a head-preserving procedure in young adults. The mean age of the patients was 28 years (range, 18-46 years). Using the Ficat-Arlet classification, 40 hips had Stage II and 20 hips had Stage III involvement. According to the classification system of Shimizu et al., the extent of the lesions were Grade C in 54 hips and Grade B in six hips; the location of the lesions were Grade c in 56 hips and Grade b in four hips. Minimum followup was 18 months (mean, 84 months; range, 18-156 months). The mean preoperative Harris hip score was 44.7 points (range, 32-62 points) which improved to an average postoperative score of 80.1 points (range, 44-100 points) at the latest followup. Forty-four hips showed no radiographic evidence of progression of collapse. Ten hips showed progressive collapse, seven hips showed progressive varus deformity, three hips had stress fractures of the femoral neck, and one hip had infection. We believe TRO with varization is worth attempting for extensive osteonecrosis of the femoral head in young adults, although failures and complications are not uncommon.

show abstract

Cementless Total Hip Arthroplasty in Patients With Osteonecrosis of the Femoral Head

Cited by 43 publications

References 0 publications

Cementless Spotorno tapered titanium stems

Cementless Spotorno tapered titanium stems

Vascularised greater trochanter bone graft, combined free iliac flap and impaction bone grafting for osteonecrosis of the femoral head

Transtrochanteric Rotational Osteotomy for Nontraumatic Osteonecrosis of the Femoral Head in Young Adults

Contact Info

Product

Resources

About