title: Hip osteonecrosis: does prior hip surgery alter outcomes compared to an initial primary total hip arthroplasty?
abstract: The purpose of this study was to assess the clinical and radiographic outcomes of total hip arthroplasty (THA) in patients who had osteonecrosis to see if prior hip preserving surgery affected outcomes. Implant survivorship, Harris hip scores, and radiographic outcomes were compared between 87 patients (92 hips) who had undergone prior hip preserving procedures and 105 patients (121 hips) who had only undergone THA. Patients were also sub-stratified into low- and high-risk groups for osteonecrosis. At a mean follow-up of 75 months, there were no significant differences in survivorship, clinical, and radiographic outcomes among the cohorts. Higher revision rates were associated with patients who were in the high-risk group. The authors believe that hip joint preserving procedures may not adversely affect the outcomes of later THA in patients with osteonecrosis.
authors.affiliation: Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland.
authors.forename: Kimona
authors.initials: K
authors.lastname: Issa
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Johnson
authors.forename: Qais
authors.initials: Q
authors.lastname: Naziri
authors.forename: Harpal S
authors.initials: HS
authors.lastname: Khanuja
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Delanois
authors.forename: Michael A
authors.initials: MA
authors.lastname: Mont
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D005271:Femur Head Necrosis / Q000601:surgery; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000601:surgery*; D011475:Prosthesis Failure; D012086:Reoperation; D016896:Treatment Outcome; D055815:Young Adult
keywords: avascular necrosis; hip preserving surgery; implant survivorship; osteonecrosis; risk factors; total hip arthroplasty