title: Alumina-alumina total hip arthroplasty for the sequelae of Legg-Calve-Perthes disease: A comparative study with adult-onset osteonecrosis.
abstract: BACKGROUND
  Total hip arthroplasty (THA) for sequelae of Legg-Calve-Perthes disease (LCPD) involves specific concerns for deformity, leg length discrepancy (LLD), and relatively young age. Excellent long-term outcome has been proven after Alumina-Alumina (Al-Al) THA for relatively young patients, however, there was no study for Al-Al THA for LCPD sequelae. The aim of this study is to evaluate the results of Al-Al THA for LCPD sequelae and to compare the results with those for adult-onset ONFH, in which THA is necessitated in relatively young age and excellent long term outcome has been proven after Al-Al THA.
  
  
  METHODS
  Between 1997 and 2007, 41 Al-Al THA were performed in 37 patients with LCPD sequelae and followed-up for mean 10.4 years. Mean age at THA was 43.6 years. Using the propensity score matching, 41 THAs in 37 patients were identified from 339 hips in 256 patients with ONFH. The medical record and radiographic data was retrospectively reviewed.
  
  
  RESULTS
  During follow-up, no revision was performed in both group. Harris Hip Score increased from 66.7 ± 17.4 points to 96.8 ± 6.8 points in LCPD group and from 47.9 ± 18.4 to 96.6 ± 4.6 in ONFH group. LLD decreased significantly from 2.0 ± 1.2 cm to 0.2 ± 0.9 cm in LCPD group and from 0.5 cm to 0.1 cm in ONFH group. Postoperative LLD showed no difference in both groups. As for complication, rate of intraoperative femoral fracture was significantly higher in LCPD group than in ONFH group. Other postoperative complication showed no difference.
  
  
  CONCLUSIONS
  Despite the higher rate of intraoperative femoral crack, outcomes of Al-Al THA for LCPD were comparable to those for ONFH. Similar to ONFH, Al-Al THA may be a reliable treatment option for LCPD.
authors: Department of Orthopedic Surgery, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Orthopedic Surgery, SMG-SNU Boramae Medical Center, 20, Boramae-ro-5-gil, Dongjak-gu, Seoul 070601, Republic of Korea.
authors: Soong Joon
authors: SJ
authors: Lee
authors: Department of Orthopedic Surgery, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Orthopedic Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea. Electronic address: jjyos@snu.ac.kr.
authors: Jeong Joon
authors: JJ
authors: Yoo
authors: Department of Orthopedic Surgery, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Orthopedic Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Medical Research Center, Seoul National University, 103 Daehak-ro, Jongno-gu Seoul 03080, Republic of Korea.
authors: Hee Joong
authors: HJ
authors: Kim
mesh_terms: D000328:Adult; D017668:Age of Onset; D000537:Aluminum Oxide; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D001843:Bone Cements; D015331:Cohort Studies; D005260:Female; D005271:Femur Head Necrosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007873:Legg-Calve-Perthes Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011474:Prosthesis Design / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements; D000537:Aluminum Oxide