Treatment of the advanced stage avascular necrosis of femoral head combined with severe femoral anteversion with total hip arthroplasty

Yan Huang; Zhuangwen Liao; Hailan HU; Wenduo Huang; Yueping Liang; Shengbiao Wang

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Treatment of the advanced stage avascular necrosis of femoral head combined with severe femoral anteversion with total hip arthroplasty

VernacularTitle:人工关节置换治疗晚期股骨头缺血性坏死合并严重股骨颈前倾角畸形
Author: Yan HUANG ; Zhuangwen LIAO ; Hailan HU ; Wenduo HUANG ; Yueping LIANG ; Shengbiao WANG
Publication Type:Journal Article
Keywords: Femoral head necrosis,iscbemic; Arthroplasty,replacement,hip; Femoral anteversion deformity
From: Chinese Journal of Trauma 2009;25(5):433-436
CountryChina
Language:Chinese
Abstract: Objective To explore the operative method and clinical effect of total hip arthroplasty with normal prosthesis in treatment of the advanced stage avascular necrosis of femoral head combined with severe femoral anteversion. Methods There were 15 patients ( 15 hips) including nine males and six females, at age range of 30-42 years (mean 37 years). The femoral anteversion was 40°-50° and Harris score of (59 ± 8) points. Total hip arthroplasty with normal prosthesis was performed to reduce the femoral anteversion for 20°-30° and increase the acetabulum anteversion for 10°-15°so as to recover a good involution relationship of the femoral head and the acetabulum and avoid anterior dislocation. The imaging examination and Harris scoring were performed regularly postoperatively. Results A follow-up for mean 2.9 years (2.5-3.7 years) in 15 patients showed that all patients obtained good range of joint motion and good stability of all the hip prostheses. Harris score was (88±6) points at 2 years post-opera-tively, which was significantly better than preoperation (P < 0.01 ). Conclusions Total hip arthro-plasty with normal prosthesis can obtain good involution of the femoral head and the acetabulum in patients with advanced stage avascular necrosis of femoral head combined with severe femoral anteversion by simul-taneously regulating implant angle of femoral prosthesis and acetabular cup, which helps avoid use of small or specially made femoral stem or subtrochanteric derotational osteotomy.