Skip to main content
SpringerLink
Log in

Arthroplasty in patients with extensive femoral head avascular necrosis

Cementless arthroplasty in extensive femoral head necrosis

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to investigate the outcomes of using cementless femoral stem for extensive osteonecrosis of the femoral head involving the proximal femur.

Methods

A total of 21 patients (27 hips) in the study group defined as extensive ONFH involving proximal femur and 42 patients (52 hips) with the diagnosis of regular osteonecrosis of the femoral head in the control group were enrolled in the study. Clinical and radiographic follow-ups were documented at three, six, 12 and 24 months postoperatively.

Results

Results improved for Harris hip score in both groups. In the study group undersized stem implantation and lateralized mal-position were identified. Subsequent subsidence was also found.

Conclusions

Pre-operative templating and intra-operative X-ray confirmation are necessary to avoid complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Malizos KN, Karantanas AH, Varitimidis SE, Dailiana ZH, Bargiotas K, Maris T (2007) Osteonecrosis of the femoral head: etiology, imaging and treatment. Eur J Radiol 63(1):16–28

    Article  PubMed  Google Scholar 

  2. Mont MA, Hungerford DS (1995) Non-traumatic avascular necrosis of the femoral head. J Bone Joint Surg Am 77(3):459–474

    CAS  PubMed  Google Scholar 

  3. Kim YH, Kim VE (1993) Uncemented porous-coated anatomic total hip replacement. Results at six years in a consecutive series. J Bone Joint Surg (Br) 75(1):6–13

    CAS  Google Scholar 

  4. Kim YH, Park JW, Kim JS, Kang JS (2014) Long-term results and bone remodeling after THA with a short, metaphyseal-fitting anatomic cementless stem. Clin Orthop Relat Res 472(3):943–950. doi:10.1007/s11999-013-3354-3

    Article  PubMed Central  PubMed  Google Scholar 

  5. Laroche M, Costa L, Bernard J, Puget J, Constantin A, Cantagrel A, Mazières B (1998) Dual-energy X-ray absorptiometry in osteonecrosis of the femoral head. Rev Rhum Engl Ed 65(6):393–396

    CAS  PubMed  Google Scholar 

  6. Calder JD, Hine AL, Pearse MF, Revell PA (2008) The relationship between osteonecrosis of the proximal femur identified by MRI and lesions proven by histological examination. J Bone Joint Surg (Br) 90(2):154–158. doi:10.1302/0301-620X.90B2.19593

    Article  CAS  Google Scholar 

  7. Calder JD, Pearse MF, Revell PA (2001) The extent of osteocyte death in the proximal femur of patients with osteonecrosis of the femoral head. J Bone Joint Surg (Br) 83(3):419–422

    Article  CAS  Google Scholar 

  8. Kim YH, Kim JS (2004) Histologic analysis of acetabular and proximal femoral bone in patients with osteonecrosis of the femoral head. J Bone Joint Surg Am 86-A(11):2471–2474

    PubMed  Google Scholar 

  9. Tingart M, Beckmann J, Opolka A, Matsuura M, Schaumburger J, Grifka J, Grässel S (2009) Analysis of bone matrix composition and trabecular microarchitecture of the femoral metaphysis in patients with osteonecrosis of the femoral head. J Orthop Res 27(9):1175–1181. doi:10.1002/jor.20873

    Article  PubMed  Google Scholar 

  10. Gruen TA, McNeice GM, Anstutz HC (1979) “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res 141:17–27

    PubMed  Google Scholar 

  11. DeLee JG, Charnley J (1976) Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res 121:20–32

    PubMed  Google Scholar 

  12. Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty: an end result study using a new method of result evaluation. J Bone Joint Surg Am 51(4):737–755

    CAS  PubMed  Google Scholar 

  13. Bumbasirevic M, Stevanovic M, Bumbasirevic V, Lesic A, Atkinson HD (2014) Free vascularised fibular grafts in orthopaedics. Int Orthop 38(6):1277–1282. doi:10.1007/s00264-014-2281-6

    Article  PubMed Central  PubMed  Google Scholar 

  14. Gagala J, Tarczyńska M, Gawęda K (2013) Clinical and radiological outcomes of treatment of avascular necrosis of the femoral head using autologous osteochondral transfer (mosaicplasty): preliminary report. Int Orthop 37(7):1239–1244. doi:10.1007/s00264-013-1893-6

    Article  PubMed Central  PubMed  Google Scholar 

  15. Issa K, Naziri Q, Maheshwari AV, Rasquinha VJ, Delanois RE, Mont MA (2013) Excellent results and minimal complications of total hip arthroplasty in sickle cell hemoglobinopathy at mid-term follow-up using cementless prosthetic components. J Arthroplasty 28(9):1693–1698. doi:10.1016/j.arth.2013.03.017

    Article  PubMed  Google Scholar 

  16. Vidalain JP (2011) Twenty-year results of the cementless Corail stem. Int Orthop 35(2):189–194. doi:10.1007/s00264-010-1117-2

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This is a retrospective study. For this type of study formal consent is not required.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, The First Hospital of Jilin University, Xinmin St 71, Changchun, China

    Yu-Hang Gao, Shu-Qiang Li, Chen Yang, Jian-Guo Liu & Xin Qi

  2. Department of Orthopaedic Surgery, Xinxiang Central Hospital, Xinxiang, China

    Yun-Feng Wang

Authors
  1. Yu-Hang Gao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shu-Qiang Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yun-Feng Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chen Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jian-Guo Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Xin Qi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Xin Qi.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gao, YH., Li, SQ., Wang, YF. et al. Arthroplasty in patients with extensive femoral head avascular necrosis. International Orthopaedics (SICOT) 39, 1507–1511 (2015). https://doi.org/10.1007/s00264-015-2693-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-015-2693-y

Keywords

Search

Navigation