Cementless total hip arthroplasty with alumina bearings in patients younger than fifty with femoral head osteonecrosis.
BACKGROUND
There are conflicting reports with respect to the outcomes of total hip arthroplasties with ceramic bearings in young patients with osteonecrosis of the femoral head. We prospectively investigated the outcomes after cementless total hip arthroplasties with contemporary alumina bearings in patients with osteonecrosis of the femoral head in this age group.


METHODS
We prospectively followed sixty patients (seventy-one hips) with a mean age of 39.1 years for an average of 7.1 years. All procedures were performed at the same institution by one surgeon, and the results were evaluated serially. The clinical evaluations included use of the Harris hip score, and activities of daily living were evaluated with use of the criteria of Johnston et al.


RESULTS
The mean Harris hip score was 97.0 points at the time of final follow-up. Thirteen patients (fourteen hips, 20%) reported noise in the hip. Loosening or osteolysis was not observed in any hip, and no prosthesis had been revised. No hip had dislocated, and no ceramic fracture had occurred.


CONCLUSIONS
After a minimum of six years of follow-up, this cementless total hip arthroplasty with contemporary alumina bearings was found to be a promising procedure for young, active patients with osteonecrosis of the femoral head. However, we remain concerned about the long-term implications of the noise that was reported in these hips.
Baek
Seung-Hoon
SH
Department of Orthopaedic Surgery, Catholic University of Daegu Hospital, 3056-6 Dae-Myung-4, Nam-Gu, Daegu 705-718, South Korea. insideMe@paran.com
Kim
Shin-Yoon
SY
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D016009:Chi-Square Distribution; D005260:Female; D005271:Femur Head Necrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009622:Noise; D010147:Pain Measurement; D011446:Prospective Studies; D011474:Prosthesis Design; D011859:Radiography; D012307:Risk Factors; D016896:Treatment Outcome