A comparison between total hip replacement for osteonecrosis and degenerative joint disease.
There has been some reluctance to perform total hip replacement on younger patients with osteonecrosis because of the poor results reported in the earlier literature. To determine the extent to which advances in surgical technique and prosthesis design have led to improved results, we evaluated 203 total hip replacements performed for osteonecrosis and compared them to 300 performed for degenerative joint disease. The failure rate for all femoral and acetabular components combined was 3.7% (22 of 600), in degenerative joint disease and 10.1% (41 of 406) in osteonecrosis. However, results with the most recently used acetabular component, the noncemented HGP-1, were markedly improved over earlier components in both conditions, with only 1 failure in 235 hips (0.4%). The increased survivorship of THR in osteonecrosis with improved component design and surgical technique is encouraging. Total hip replacement is a good option for patients with advanced stages of osteonecrosis, and similar surgical indications should be used for patients with degenerative joint disease and other disorders.
Steinberg
Marvin E
ME
Department of Orthopedic Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
Lai
Max
M
Garino
Jonathan P
JP
Ong
Alvin
A
Wong
Kirk L
KL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000453:epidemiology* / Q000601:surgery*; D010020:Osteonecrosis / Q000453:epidemiology* / Q000601:surgery*; D010414:Pennsylvania / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult