title: Contemporary total hip arthroplasty with and without cement in patients with osteonecrosis of the femoral head: a concise follow-up, at an average of seventeen years, of a previous report.
abstract: We previously evaluated ninety-eight consecutive patients (148 hips) at mean of 9.3 years after total hip arthroplasty; the mean age at the time of the index surgical procedure was 47.3 years. Fifty patients (100 hips) had simultaneous bilateral arthroplasty with a cemented stem in one hip and a cementless stem in the contralateral hip. Forty-eight patients (forty-eight hips) had unilateral hip arthroplasty with a cementless stem. All patients had a cementless acetabular component. In our first report, we found no difference in clinical results, as measured with the Harris hip score and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), between the cementless and cemented stems. One hip (2%) in the hybrid group (a cementless cup and a cemented stem) had revision because of infection and two hips (2%) in the fully cementless group had revision of the femoral component because of a periprosthetic fracture. Between the time of follow-up in that study (at a mean of 9.3 years) and the time of follow-up in the present study (at a mean of 17.3 years), twenty-two revisions of acetabular components were performed, with eight in the hybrid group and fourteen in the fully cementless group. There was no difference in clinical results, as measured with the Harris hip score and the WOMAC, between the hybrid and fully cementless groups. At the time of the present review, forty (83%) of forty-eight acetabular components in the hybrid group and eighty (85%) of ninety-four acetabular components in the fully cementless group were intact. Most of the femoral components (98%) in both groups were intact. Wear and periacetabular osteolysis were the causes of failure in the hips requiring revision.
authors: The Joint Replacement Center of Korea, Ewha Womans University MokDong Hospital, 911-1, Mokdong, YangChun-Gu, Seoul 158-710, South Korea. younghookim@ewha.ac.kr
authors: Young-Hoo
authors: YH
authors: Kim
authors: Jun-Shik
authors: JS
authors: Kim
authors: Jang-Won
authors: JW
authors: Park
authors: Jong-Hwan
authors: JH
authors: Joo
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D001843:Bone Cements / Q000627:therapeutic use*; D005260:Female; D005271:Femur Head Necrosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D020127:Recovery of Function; D012086:Reoperation; D013997:Time Factors; D016896:Treatment Outcome; D016474:Weight-Bearing
chemical_list: D001843:Bone Cements