Uncemented ceramic-on-ceramic THA in adults with osteonecrosis of the femoral head.
Advanced osteonecrosis of the femoral head is increasingly treated with uncemented total hip arthroplasty (THA), particularly in the younger population. While early outcomes appear promising, little is known about the optimum bearing surface in this patient subpopulation. The goal of this study was to evaluate the clinical and radiological outcomes of uncemented ceramic-on-ceramic THA in young adults with osteonecrosis of the femoral head. Twenty-four consecutive patients (24 hips) with osteonecrosis of the femoral head and 24 patients (24 hips) with osteoarthritis were treated with an uncemented ceramic-on-ceramic THA. Mean patient age for the osteonecrosis group was 46 years and for the osteoarthritis group was 50 years. At a mean follow-up of 34 months, functional improvement was significant in both groups (P<.01). The outcome was good to excellent for 85% of patients (17 hips) in the osteonecrosis group and 90% of patients (19 hips) in the osteoarthritis group. Harris and Oxford Hip scores were significantly better (P<.05) in the osteoarthritis group than in the osteonecrosis group at 6 months postoperatively but at no other assessment visit. Our results suggest that ceramic-on-ceramic THA in osteonecrotic patients produces similar clinical and radiological outcomes to those with osteoarthritis at a minimum 24-month follow-up. Ceramic-on-ceramic uncemented THA is therefore a useful adjunct for the treatment of advanced osteonecrosis of the femoral head.
Institute of Infection, Immunity, and Inflammation, College of Medicine, Veterinary, and Life Sciences, University Of Glasgow, Scotland, United Kingdom. nlmillar@yahoo.com
Neal L
NL
Millar
Mansur
M
Halai
Rosaleen
R
McKenna
Iain W W
IW
McGraw
Lauren L
LL
Millar
Maher
M
Hadidi
D000203:Activities of Daily Living; D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation / Q000379:methods*; D002484:Cementation; D002516:Ceramics; D005260:Female; D005271:Femur Head Necrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D011183:Postoperative Complications; D011474:Prosthesis Design; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D016896:Treatment Outcome