Cementless total hip arthroplasty in the treatment of patients with femoral head necrosis
- VernacularTitle:非骨水泥全髋关节置换术治疗股骨头缺血性坏死的中期疗效评估
- Author:
Hui ZHANG
;
Fuxing PEI
;
Bin SHEN
- Publication Type:Journal Article
- Keywords:
Arthroplasty, replacement, hip;
Prosthesis failure;
Femur head necrosis
- From:
Chinese Journal of Orthopaedics
1998;0(12):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate mid-term clinical and radiographic outcomes associated with cementless total hip arthroplasty(THA) in a consecutive series of patients with osteonecrosis of the femoral head. Methods This study examined the mid-term (equal to or more than 5 years) results of THA. From January 1998 to March 2001, a series of 71 patients (80 hips) who had undergone THA with cementless components in our hospital were involved in this study. All patients were evaluated both clinically and radiographically. Clinical outcomes were evaluated according to Harris evaluation score. Components migration, bone changes around the implant, the polyethylene wear rate and direction of the acetabular polyethylene wear were measured radiologically. Kaplan-Meier analysis was performed to evaluate the survival of the femoral and acetabulum components. End point was radiographical loosening or revision of the acetabular component, and revision of the femoral component for any reason. Results 62 hips in 54 patients were followed up at least 5 years. The mean Harris hip score improved from preoperation (44.0?8.4) points to (92.4?5.7) points at the time of final follow-up. No component was seen to be loose radiographically or had been revised because of any reason at the time of final follow-up. Only one focal area of pelvic osteolysis in one patient and twelve small focal areas of femoral osteolysis in another patient were identified. The mean linear wear rate was (0.125?0.074) mm/year. When loosening was used as the end point for failure, the survival rate of the acetabular and femoral components was 1.0 (95% confidence interval, 0.98 to 1.00) in both groups. Conclusion Cementless THA in patients with osteonecrosis of the hip had a satisfactory clinical and radiographic outcome at a minimum of five years follow-up. Because polyethylene wear and osteolysis can not avoided, radiographical follow-up for cementless components is very important.