Total Hip Replacement in the Treatment of Steroid-induced Osteonecrosis of the Femoral Head
10.4055/jkoa.1983.18.1.153
- Author:
Seong Do CHO
;
Sang Yo HAN
;
Young Tae KIM
;
Duk Yun CHO
;
Key Yong KIM
- Publication Type:Original Article
- Keywords:
Steroid;
Osteonecrosis;
Femoral head;
Total hip replacement
- MeSH:
Adrenal Cortex Hormones;
Arthralgia;
Arthritis, Rheumatoid;
Arthroplasty, Replacement, Hip;
Bone Transplantation;
Classification;
Female;
Follow-Up Studies;
Head;
Hemiarthroplasty;
Hip;
Humans;
Humeral Head;
Life Style;
Low Back Pain;
Male;
Methods;
Osteonecrosis;
Osteotomy;
Surgeons
- From:The Journal of the Korean Orthopaedic Association
1983;18(1):153-160
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Since 1957, multiple possible mechanisms have been suggested to explain the production of the osteonecrosis of the femoral head and it is now accepted that steroid medication is one of the etiologic factors producing osteonecrosis of the femoral head. Among the surgical procedures in ischemic osteonercrosis of the femoral head are bone grafting, core decom-pression, rotational osteotomy, angulation osteotomy, hemiarthroplasty and total hip replacement. The choice of surgical procedures in the management of idiopathic osteonecrosis of the femoral head is dependent on several factors. Most important are the etiology and stage of the lesion. Other considerations are the patients age, lifestyle, and demands on his hip, and the surgeons preference and expertise. We reviewed 32 total hip replacements in 22 patients, which had been performed to treat steroid-induced osteonecrosis of the femoral head at Department of Orthopaedic Surgery, National Medical Center from Jan. 1975 to Dec. 1981. The longest follow-up was 7 years and 6 months and the shortest, 1 year, the average being 2 years and 6 months. The results were as follows: 1. There were 13 males and 9 females and more than half were in 5th decade. 2. Principal causes to use oral corticosteroids were rheumatoid arthritis, arthralgia, and low back pain in the order of frequency. 3. Duration of corticosteroid medication was between 2 months and 12 years and 18 patients took more than 12 months. 4. Of 18 patients who had the bilateral involvement, the two also had osteonecrosis of the humeral head. 5. Roentgenographically, 30 hips were in stage IV and 2, in stage III according to the classification of Arlet and Ficat. 6. Types of the implants used were Charnely (28 cases), MQller (2 cases) and Trapezoidal-28 (3 cases). 7. The function of the each hip was evaluated preoperatively and postoperatively by the method of Wilson and Salvati and all improved from average poor to average good.
