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THA using an anatomic stem in patients with femoral head osteonecrosis

Cited 7 time in Web of Science Cited 9 time in Scopus
Authors
Ha, Yong-Chan; Kim, Hee Joong; Kim, Shin-Yoon; Kim, Tae-Young; Koo, Kyung-Hoi
Issue Date
2008-03-11
Publisher
Lippincott, Williams & Wilkins
Citation
Clin Orthop Relat Res. 2008;466(5):1141-1147
Keywords
Acetabulum/radiographyArthroplasty, Replacement, Hip/adverse effects/*instrumentation/methodsBiocompatible MaterialsDurapatiteFemaleFemur/physiopathology/radiography/*surgeryFemur Head Necrosis/mortality/physiopathology/radiography/*surgeryFollow-Up StudiesHip Joint/physiopathology/radiography/*surgery*Hip ProsthesisHumansMaleMiddle AgedOsteolysis/etiology/radiographyPolyethyleneProsthesis DesignProsthesis FailureReoperationRetrospective StudiesStress, MechanicalTime FactorsTreatment Outcome
Abstract
Treating young patients with femoral head osteonecrosis (ON) remains challenging. Anatomic stems were introduced in the 1980s and 1990s to improve the proximal canal fit in an attempt to enhance long-term implant survival, an important aspect of treating young patients. We began using one design in 1993 and asked three questions to confirm whether the design criteria improved outcomes in patients with ON: (1) What is the long term survivorship of these implants?; (2) What is the amount and rate of wear?; and (3) What is the incidence of osteolysis? We retrospectively reviewed 56 patients (69 hips) who underwent THA for femoral head ON with a cementless anatomic stem proximally coated with hydroxyapatite. Four patients (four hips) were lost to followup and 16 patients (19 hips) died. In the remaining 36 patients (46 hips) the minimum followup was 10 years (mean, 11.2 years; range, 10-13 years). The mean age at operation was 48.6 years. The average Harris hip score at last followup was 87 points. Worst-case survivorship was 58.1% at 13 years and best-case was 93.3%. The average linear wear of the polyethylene liner was 2.02 mm and the average annual wear was 0.18 mm per year. Thirty-seven hips (80%) had femoral osteolysis and 14 (30%) had acetabular osteolysis. One patient who had extensive femoral osteolysis and stem loosening was revised at 11.2 years postoperatively. The high rates of polyethylene wear and osteolysis are of concern.
ISSN
0009-921X (Print)
Language
English
URI
http://www.springerlink.com/content/m634m604228p5534/fulltext.pdf

https://hdl.handle.net/10371/67483
DOI
https://doi.org/10.1007/s11999-008-0202-y
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College of Medicine/School of Medicine (의과대학/대학원)Orthopedic Surgery (정형외과학전공)Journal Papers (저널논문_정형외과학전공)
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