Hip replacement in femoral head osteonecrosis: current concepts

Scaglione, Michelangelo; Fabbri, Luca; Celli, Fabio; Casella, Francesco; Guido, Giulio

doi:10.11138/ccmbm/2015.12.3s.051

Cited by 21 publications

(18 citation statements)

References 31 publications

(27 reference statements)

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“…This will eventually lead to articular cartilage damage and osteoarthritis of the joint [ 1 ]. The four main etiologies of ONFH are idiopathic, dyslipidemia, chronic alcoholism, and corticosteroid treatment [ 2 ]. During the early stages of the disease, conservative treatments have been advocated [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Early results of total hip arthroplasty using dual-mobility cup in patients with osteonecrosis of the femoral head

Assi¹,

Kheir²,

Samaha³

et al. 2018

SICOT-J

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Introduction: Osteonecrosis of the femoral head (ONFH) remains a therapeutic challenge for patients undergoing total hip arthroplasty (THA). The majority of these patients are young with high functional demand, and show an increased risk of dislocation following surgery than patients with osteoarthritis. The use of double mobility cup (DMC) has been linked with lower rates of complications when compared to conservative cups; however, the literature is scarce over DMC results in patients with ONFH. The aim of the study is to report the early outcomes of patients with ONFH treated with THA-DMC. Materials: A retrospective analysis of patients suffering from ONFH who underwent THA using DMC (THA-DMC) from 2006 to 2015 were evaluated for functional status and risk of post-operative complications. Thirty THA-DMC in 26 patients with a mean follow-up of 51 months were evaluated clinically (modified Hip Harris Score) and radiologically. Results: The mean age of the included patients was 54.9 years. At final follow-up, the mean modified Hip Harris score was 98.7 ± 2.7 and no dislocation episodes or revision surgeries were recorded. The radiological assessment revealed no signs of migration/tilting, radiolucent lines, periprosthetic osteolysis or heterotopic ossification over the DMC component and the femoral stem. The survival rate over 51 months of follow-up was 100%. Discussion: The use of the new generation of dual mobility cup in patients with ONFH showed excellent functional early results with no major complications such as dislocation.

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Section: Introductionmentioning

confidence: 99%

Early results of total hip arthroplasty using dual-mobility cup in patients with osteonecrosis of the femoral head

Assi¹,

Kheir²,

Samaha³

et al. 2018

SICOT-J

View full text Add to dashboard Cite

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“…Osteonecrosis of the femoral head (ONFH) is a disease that commonly affects young adults, characterizing by progression of subchondral fracture and collapse. [1][2][3] Collapse in ONFH can lead to hip osteoarthritis and disability, often requiring hip replacement. Because the majority of ONFH patients are young, they inevitably require several operations to preserve the affected joint.…”

Section: Introductionmentioning

confidence: 99%

The Glycosaminoglycan Content of Hip Cartilage in Osteonecrosis of Femoral Head: Evaluation with Delayed Gadolinium-Enhanced Magnetic Resonance Imaging of Cartilage

et al. 2018

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Objective Hip cartilage quality is essential for the success of joint-preserving surgery for osteonecrosis. This study aimed to characterize cartilage changes in osteonecrosis of femoral head (ONFH) using delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC). Design Fifteen asymptomatic (control) and 60 ONFH subjects were included in this study. The ONFH subjects were stratified in accordance with the Association Research Circulation Osseous (ARCO) classification ( n = 15 hips per ARCO stage). All participant hips were investigated using dGEMRIC and theT1Gd data were collected and analyzed. Results T1Gd value was significantly lower in the ONFH group (365.1 ± 90.5 ms; range 200-498 ms) compared with the control group (546.1 ± 26.0 ms; range 504-580 ms) ( P < 0.001). The T1Gd values of ARCO stage I-IV ONFH were 460.2 ± 17.3 ms (439-498 ms), 408.9 ± 43.4 ms (337-472 ms), 359.9 ± 34.5 ms (303-412 ms), 231.5 ± 15.1 ms (200-253 ms), respectively. Decreased T1Gd value was found to correlate significantly with increased ONFH severity ( P < 0.001). T1Gd value in collapse stage was significantly lower than that of noncollapse stage (295.7 ± 70.3 ms [range 200-412 ms] vs. 434.6 ± 41.7 ms [range 337-498 ms]; P < 0.001). Conclusions dGEMRIC identified hip cartilage as abnormal in ONFH, even at early-stage, as represented by decreased T1Gd, and this was further aggravated by ONFH collapse.

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“…There is no gold standard management for this disease and involves multiple approaches. 17 The main goal of the present study was to analyse and to recommend the management of osteonecrosis of femoral head in young patients by surface replacement of femoral head as ideal procedure.…”

Section: Discussionmentioning

confidence: 99%

Treatment of osteonecrosis of femoral head in young patients by surface replacement of femoral head

et al. 2017

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Background: Osteonecrosis of hip is a pathological condition that affects usually young adults. Articular surface replacement (ASR) is considered to be a viable option in young patients. The study was done with the aim to analyse and to recommend the management of osteonecrosis of femoral head in young patients by surface replacement of femoral head as ideal procedure.Methods: The present study was conducted in 30 patients with osteonecrosis of the femoral head who attended to OPD at Santhiram Medical College and General Hospital, Nandyal, A.P during the period of April 2016 to September 2017. Articular surface replacement of the femoral head was the surgical procedure done in all the patients. The success of the treatment was analysed by Harris hip scoring.Results: Maximum number of patients (60%) was below 40 years of age. Male dominance (77%) was seen in the study. According to Ficat and Arlet classification 12 cases (40%) were under the category of stage II-B and 18 cases (60%) were of stage III. Postoperatively about 90% of patients had postoperative Harris hip score of >80 points. Surgery was succeeded in 10 hips of stage II-B and 15 hips in stage III. According to Harris hip scoring excellent results were obtained in 15 (50%), good in 12 (40%), fair in 2 (6.67%) and poor result 1 (3.3%) patient.Conclusion: The study concludes that the surface replacement is an anatomical hip arthroplasty with preservations of more than 70% of bone stock of femoral head and the ability of the patients to sit cross-legged and squat, which is the desire of the Indian population.

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Hip replacement in femoral head osteonecrosis: current concepts

Cited by 21 publications

References 31 publications

Early results of total hip arthroplasty using dual-mobility cup in patients with osteonecrosis of the femoral head

Early results of total hip arthroplasty using dual-mobility cup in patients with osteonecrosis of the femoral head

The Glycosaminoglycan Content of Hip Cartilage in Osteonecrosis of Femoral Head: Evaluation with Delayed Gadolinium-Enhanced Magnetic Resonance Imaging of Cartilage

Treatment of osteonecrosis of femoral head in young patients by surface replacement of femoral head

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