[Effect of osteonecrosis on bone density and its management on the results of revision arthroplasty of the hip].
128 hips after revision arthroplasty in 115 patients which had been operated in our Ward in 1990-2001 were retrospectively evaluated. There were 99 women and 16 men with mean age: 68.9 years old. The mean time of follow-up was 28.6 months (form 3 to 120 months). In 98 hips there were aseptic loosening of the both elements of the prosthesis, in 13 hips there were aseptic loosening of the stem, in 17 hips there were aseptic loosening of the cup only. Cement total hip rearthroplasty was made in 112 cases and cementless total hip rearthroplasty was made in 16 hips. In presented material there were used the acetabular bone grafts in 114 cases, and the femoral bone grafts in 97 cases--all with allogenic frozen bone grafts. The additional implants were used in 31 cases (meshwork, wire, screw). The bone defects in acetabulum and femoral stem was based on Paprovsky classification. There were good and excellent results in 90% and poor or bad results in 10% according to clinical and radiological evaluation. Mean clinical result was 78.5 p. in Harris Hip Score. The radiological results were poor in 13 hips (according to criterion proposed by joined committee of The Hip Society, SICOT and AAOS). Osteointegration of bone allografts was radiologically confirmed in 81% of cases. Complication rates is 20%. There is no correlation between the type of acetabular or femoral bone defects and results of revision hip arthroplasty. Poor results are correlated with use of SKT or Weller stem. Wagner femoral osteotomy and the lack of bone allografts healing.
Dutka
Julian
J
Oddział Chirurgii Ortopedyczno-Urazowej, Szpital Specjalistyczny im. Stefana Zeromskiego w Krakowie.
Sosin
Paweł
P
Urban
Mariusz
M
Libura
Marek
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D015519:Bone Density; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000379:methods / Q000706:statistics & numerical data; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D010020:Osteonecrosis / Q000209:etiology*; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods; D011044:Poland; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome