[Results of the uncemented total hip arthroplasty in avascular necrosis of the femoral head].
OBJECTIVE
The results from 56 patients with osteonecrosis of the femoral head who underwent 66 uncemented total hip replacements were analyzed and compared with current reports in the literature on cemented endoprosthesis.


METHODS
In the retrospective study in 30 of those cases the Zweymüller and in 25 cases the HA-coated ABG prosthesis were used. In addition the results of 11 patients with a polyethylene Endler cup in combination with a Zweymüller stem are presented. The mean age at surgery was 48 years, the mean follow-up was 5.9 years. Clinical examination, registration of the Merle d'Aubigné score and a radiological examination were performed.


RESULTS
The clinical results did not show any differences between the used prostheses. A more favourable outcome with regard to the Merle d'Aubigné score was demonstrated for the Zweymüller and ABG prostheses. No loosening of the stem was found. Revision as a consequence of aseptic loosening of the acetabular component was done in 7,5 % (27,3 % of the Endler cups and 8 % of the ABG cups). 20 % of the patients with an ABG prosthesis showed acetabular osteolysis of various degrees. This seems to be correlated with an increased polyethylene wear.


CONCLUSIONS
Recent reports in the literature about a favourable outcome in uncemented total hip arthroplasty in osteonecrosis of the femoral head can be confirmed. The unsatisfactory results of the Endler cup indicate that established types of endoprostheses should be preferred.
Delank
K S
KS
Klinik für Orthopädie der Johannes-Gutenberg-Universität Mainz, Germany. delank@mail.uni-mainz.de
Drees
P
P
Eckardt
A
A
Heine
J
J
D019644:Arthroplasty, Replacement, Hip; D005271:Femur Head Necrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012189:Retrospective Studies