AI Article Synopsis
- Poor bone quality in patients with osteonecrosis of the femoral head may lead to unfavorable outcomes after hip replacement, prompting a study on the results of cementless total hip replacement (THR) in younger patients.
- The study included 41 patients averaging 48 years of age who underwent cementless hip arthroplasty, with follow-up assessments using various clinical scores and measurements of implant migration.
- The results showed no need for hip revisions, minimal stem subsidence over five years, and overall good hip function, supporting the continued use of uncemented stems in this patient group, while acknowledging the need for ongoing monitoring of long-term outcomes.
Article Abstract
Background: Poor bone stock in patients with osteonecrosis of the femoral head may be a reason for poor outcome after hip replacement. One way of studying bone quality is to measure implant migration. We thus investigated the clinical and radiographic results of cementless THR in younger patients with femoral head osteonecrosis.
Patients And Methods: We studied hips in 41 patients (mean age 48 (25-63) years) with a cementless hip arthroplasty after late stage osteonecrosis. Clinical evaluation was by the Harris hip score, the WOMAC score and the SF-36 score. Stem subsidence was measured with the Ein Bild Roentgen Analyse femoral component analysis (EBRA-FCA) at 3, 12, 24, 60, and 72 months after operation. The average duration of follow-up was 7(1-9) years, with less than 2 years for 2 patients.
Results: There was no revision of any hip. No radiographic or clinical stem loosening was seen. After 60 months, the cementless stems showed a median subsidence of -0.7 mm (95% CI: -0.9 to -0.2). No femoral osteolysis occurred. Femoral radiolucent lines, all < 1 mm, were seen in 10 hips. At the latest follow-up the Harris hip score was 83 (23-100) points.
Interpretation: Our findings for porous-coated stems in patients with femoral osteonecrosis indicate no greater risk of stem subsidence and rate of osteolysis after an average of 7 years follow-up. Thus, we continue to use uncemented stems in younger patients with femoral osteonecrosis. However, continued follow-up will be necessary to evaluate the long-term outcome.
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| http://dx.doi.org/10.1080/17453670610013141 | DOI Listing |
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