Uncemented total hip arthroplasty in young adults with osteonecrosis of the femoral head: a comparative study.
BACKGROUND
The outcome of uncemented total hip arthroplasty in patients with osteonecrosis of the femoral head in general, and in young adults in particular, remains largely unknown. This study evaluated the clinical and radiographic results of uncemented total hip arthroplasty in young adults with osteonecrosis of the femoral head and compared these results to those seen in young adults with osteoarthritis.


METHODS
Forty-one consecutive patients with osteonecrosis of the femoral head (fifty-two hips) and forty patients with osteoarthritis (fifty-two hips) were treated with an uncemented total hip arthroplasty at our institution. The mean age for the osteonecrosis group was thirty-eight years, and, for the osteoarthritis group, forty-two years. Clinical and radiographic outcomes at a minimum of two years were assessed.


RESULTS
At a mean duration of follow-up of three years, the functional improvement was significant in both groups (p < 0.05). The outcome was good to excellent for 94% (forty-nine hips) in the osteonecrosis group and 96% (fifty hips) in the osteoarthritis group. There were two revisions in the osteonecrosis group and one revision in the osteoarthritis group. Survivorship free of revision at the time of the latest follow-up was 96.1% for the osteonecrosis group and 98% for the osteoarthritis group.


CONCLUSIONS
The short-term results of cementless total hip arthroplasty in patients with osteonecrosis of the femoral head were encouraging and comparable with the results of a matched group of patients with osteoarthritis. We await further follow-up to see if these promising results hold true.


METHODS
Therapeutic Level III. See Instructions to Authors on jbjs.org for a complete description of levels of evidence.
Mont
Michael A
MA
Center for Joint Preservation and Reconstruction, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD 21215, USA. Rhondamont@aol.com
Seyler
Thorsten M
TM
Plate
Johannes F
JF
Delanois
Ronald E
RE
Parvizi
Javad
J
D000293:Adolescent; D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D002484:Cementation; D005260:Female; D005271:Femur Head Necrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery*; D011859:Radiography; D020127:Recovery of Function; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome