Top

Archives of Orthopaedic and Trauma Surgery

Published in:

01-05-2015 | Hip Arthroplasty

Short-stem hip arthroplasty in osteonecrosis of the femoral head

Authors: Thilo Floerkemeier, Stefan Budde, Jens Gronewold, Kerstin Radtke, Max Ettinger, Henning Windhagen, Gabriela von Lewinski

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 5/2015

Abstract

Introduction

Osteonecrosis of the femoral head (ONFH) is a locally destructive and complex disorder. Without treatment, infraction of the femoral head is likely. There is also a lack of consensus in the literature about the most appropriate arthroplasty method in patients with progressive ONFH. During the last decade, the number of short-stem prostheses has increased. Some short-stem designs have a metaphyseal anchorage. It is questionable whether ONFH represents a risk factor for failure after implantation of short stems. The aim of this study was to review existing literature regarding the outcome of short-stem arthroplasty in ONFH and to present the pros and cons of short-stem hip arthroplasty in osteonecrosis of the femoral head.

Materials and methods

This review summarises existing studies on short-stem hip arthroplasty in osteonecrosis of the femoral head.

Results

Few studies have analysed the clinical and radiological outcome of short-stem THA in patients with ONFH. Only a handful of studies present clinical and radiological outcome after implantation of a short-stem arthroplasty in patients with the underlying diagnosis of osteonecrosis of the femoral head.

Conclusion

The short- to medium-term results show predominantly good outcomes. However, due to differences in the design of short stems and their fixation, it is hard to draw a general conclusion. Short stems with primary diaphyseal fixation do not reveal a high increased risk of failed osseointegration or loosening. For designs with a primary metaphyseal anchorage, an MRI should be conducted to exclude that the ostenecrosis exceeds the femoral neck.

Mont MA, Zywiel MG, Marker DR, McGrath MS, Delanois RE (2010) The natural history of untreated asymptomatic osteonecrosis of the femoral head: a systematic literature review. J Bone Joint Surg Am 92(12):2165CrossRefPubMed

Lee J, Kwok SK, Jung SM, Min HK, Nam HC, Seo JH, Ju J, Park KS, Park SH, Kim HY (2014) Osteonecrosis of the hip in Korean patients with systemic lupus erythematosus: risk factors and clinical outcome. Lupus 23(1):39CrossRefPubMed

Seyler TM, Cui Q, Mihalko WM, Mont MA, Saleh KJ (2007) Advances in hip arthroplasty in the treatment of osteonecrosis. Instr Course Lect 56:221PubMed

Mont MA, Hungerford MW (2000) Therapy of osteonecrosis. Basic principles and decision aids. Orthopade 29(5):457PubMed

Assouline-Dayan Y, Chang C, Greenspan A, Shoenfeld Y, Gershwin ME (2002) Pathogenesis and natural history of osteonecrosis. Semin Arthritis Rheum 32(2):94

Wang C, Peng J, Lu S (2014) Summary of the various treatments for osteonecrosis of the femoral head by mechanism: A review. Exp Ther Med 8(3):700PubMedCentralPubMed

Beaule PE, Amstutz HC (2004) Management of Ficat stage III and IV osteonecrosis of the hip. J Am Acad Orthop Surg 12(2):96PubMed

von Stechow D, Drees P (2007) Surgical treatment concepts for femoral head necrosis. Orthopade 36(5):451CrossRef

Bozic KJ, Zurakowski D, Thornhill TS (1999) Survivorship analysis of hips treated with core decompression for non-traumatic osteonecrosis of the femoral head. J Bone Joint Surg Am 81(2):200PubMed

10.

Hungerford DS (1995) Treatment of avascular necrosis in the young patient. Orthopedics 18(9):822PubMed

11.

Mont MA, Jones LC, Pacheco I, Hungerford DS (1998) Radiographic predictors of outcome of core decompression for hips with osteonecrosis stage III. Clin Orthop Relat Res 354:159

12.

Smith SW, Fehring TK, Griffin WL, Beaver WB (1995) Core decompression of the osteonecrotic femoral head. J Bone Joint Surg Am 77(5):674PubMed

13.

Berend KR, Gunneson EE, Urbaniak JR (2003): Free vascularized fibular grafting for the treatment of postcollapse osteonecrosis of the femoral head. J Bone Joint Surg Am 85-A(6):987

14.

Kim SY, Kim YG, Kim PT, Ihn JC, Cho BC, Koo KH (2005) Vascularized compared with non-vascularized fibular grafts for large osteonecrotic lesions of the femoral head. J Bone Joint Surg Am 87(9):2012

15.

von Salis-Soglio Freiherr, Ruff C (1988) Idiopathic femur head necrosis in the adult–results of surgical therapy. Z Orthop Ihre Grenzgeb 126(5):492CrossRef

16.

Scher MA, Jakim I (1993) Intertrochanteric osteotomy and autogenous bone-grafting for avascular necrosis of the femoral head. J Bone Joint Surg Am 75(8):1119PubMed

17.

Simank HG, Brocai DR, Brill C, Lukoschek M (2001) Comparison of results of core decompression and intertrochanteric osteotomy for nontraumatic osteonecrosis of the femoral head using Cox regression and survivorship analysis. J Arthroplasty 16(6):790CrossRefPubMed

18.

Issa K, Pivec R, Kapadia BH, Banerjee S, Mont MA (2013) Osteonecrosis of the femoral head: the total hip replacement solution. Bone Joint J 95-B(11 Suppl A):46

19.

Johnson AJ, Mont MA, Tsao AK, Jones LC (2014) Treatment of femoral head osteonecrosis in the United States: 16-year analysis of the Nationwide Inpatient Sample. Clin Orthop Relat Res 472(2):617CrossRefPubMedCentralPubMed

20.

Banerjee S, Pivec R, Issa K, Harwin SF, Mont MA, Khanuja HS (2013) Outcomes of short stems in total hip arthroplasty. Orthopedics 36(9):700CrossRefPubMed

21.

Jerosch J, Grasselli C, Kothny C (2014) Is there an indication for a partial neck preserving short stem (MiniHip) in patients with an avascular necrosis of the femoral head? Orthopädische und Unfallchirurgische Praxis 4:178

22.

Cornell CN, Salvati EA, Pellicci PM (1985) Long-term follow-up of total hip replacement in patients with osteonecrosis. Orthop Clin North Am 16(4):757PubMed

23.

Ortiguera CJ, Pulliam IT, Cabanela ME (1999) Total hip arthroplasty for osteonecrosis: matched-pair analysis of 188 hips with long-term follow-up. J Arthroplasty 14(1):21CrossRefPubMed

24.

Ritter MA, Meding JB (1986) A comparison of osteonecrosis and osteoarthritis patients following total hip arthroplasty. A long-term follow-up study. Clin Orthop Relat Res (206):139

25.

Saito S, Saito M, Nishina T, Ohzono K, Ono K (1989) Long-term results of total hip arthroplasty for osteonecrosis of the femoral head. A comparison with osteoarthritis. Clin Orthop Relat Res (244):198

26.

Babis GC, Soucacos PN (2004) Effectiveness of total hip arthroplasty in the management of hip osteonecrosis. Orthop Clin North Am 35(3):359CrossRefPubMed

27.

Johannson HR, Zywiel MG, Marker DR, Jones LC, McGrath MS, Mont MA (2011) Osteonecrosis is not a predictor of poor outcomes in primary total hip arthroplasty: a systematic literature review. Int Orthop 35(4):465CrossRefPubMedCentralPubMed

28.

Millar NL, Halai M, McKenna R, McGraw IW, Millar LL, Hadidi M (2010) Uncemented ceramic-on-ceramic THA in adults with osteonecrosis of the femoral head. Orthopedics 33(11):795PubMed

29.

Mont MA, Rajadhyaksha AD, Hungerford DS (2001) Outcomes of limited femoral resurfacing arthroplasty compared with total hip arthroplasty for osteonecrosis of the femoral head. J Arthroplasty 16(8 Suppl 1):134CrossRefPubMed

30.

Amstutz HC, Beaule PE, Dorey FJ, Le Duff MJ, Campbell PA, Gruen TA (2004) Metal-on-metal hybrid surface arthroplasty: two to six-year follow-up study. J Bone Joint Surg Am 86-A(1):28

31.

Beaule PE, Amstutz HC, Le DM, Dorey F (2004) Surface arthroplasty for osteonecrosis of the hip: hemiresurfacing versus metal-on-metal hybrid resurfacing. J Arthroplasty 19(8 Suppl 3):54PubMed

32.

Fink B, Ruther W (2000) Partial and total joint replacement in femur head necrosis. Orthopade 29(5):449PubMed

33.

Fink B, Schneider T, Conrad S, Jaeger M, Protzen M, Ruther W (2002) The thrust plate prosthesis in patients with aseptic osteonecrosis of the femoral head. Arch Orthop Trauma Surg 122(9–10):499PubMed

34.

Karatosun V, Gunal I, Unver B, Gultekin A (2006) Thrust plate prosthesis for osteonecrosis of the femoral head: short-term results of 15 patients followed 2–6 years. J Orthop Sci 11(5):450CrossRefPubMed

35.

Kim YH, Oh SH, Kim JS, Koo KH (2003) Contemporary total hip arthroplasty with and without cement in patients with osteonecrosis of the femoral head. J Bone Joint Surg Am 85-A(4):675

36.

Mont MA, Seyler TM, Plate JF, Delanois RE, Parvizi J (2006) Uncemented total hip arthroplasty in young adults with osteonecrosis of the femoral head: a comparative study. J Bone Joint Surg Am 88(Suppl 3):104CrossRefPubMed

37.

Mont MA, Seyler TM, Marker DR, Marulanda GA, Delanois RE (2006) Use of metal-on-metal total hip resurfacing for the treatment of osteonecrosis of the femoral head. J Bone Joint Surg Am 88(Suppl 3):90CrossRefPubMed

38.

Revell MP, McBryde CW, Bhatnagar S, Pynsent PB, Treacy RB (2006) Metal-on-metal hip resurfacing in osteonecrosis of the femoral head. J Bone Joint Surg Am 88(Suppl 3):98CrossRefPubMed

39.

Yasunaga Y, Goto T, Hisatome T, Tanaka R, Yamasaki T, Ochi M (2003) Bone-preserving prosthesis with a single axis for treating osteonecrosis of the femoral head: midterm results for the thrust plate hip prosthesis. J Orthop Sci 8(6):818CrossRefPubMed

40.

Zeh A, Weise A, Vasarhelyi A, Bach AG, Wohlrab D (2011) Medium-term results of the Mayo short-stem hip prosthesis after avascular necrosis of the femoral head. Z Orthop Unfall 149(2):200PubMed

41.

Shemesh S, Kosashvili Y, Heller S, Sidon E, Yaari L, Cohen N, Velkes S (2013) Hip arthroplasty with the articular surface replacement (ASR) system: survivorship analysis and functional outcomes. Eur J Orthop Surg Traumatol 24(6):925–930

42.

Takamura KM, Amstutz HC, Lu Z, Campbell PA, Ebramzadeh E (2013) Wear analysis of 39 conserve plus metal-on-metal hip resurfacing retrievals. J Arthroplast 29(2):410–415

43.

van der WW, Sijbesma T, Hoekstra HJ, Brakel K, Pilot P, Nelissen RG 2013 Treatment of pseudotumors after metal-on-metal hip resurfacing based on magnetic resonance imaging, metal ion levels and symptoms. J Arthroplast 29(2):416–421

44.

Lerch M, von den Haar-Tren Windhagen H, Behrens BA, Wefstaedt P, Stukenborg-Colsman CM (2012) Bone remodelling around the Metha short stem in total hip arthroplasty: a prospective dual-energy X-ray absorptiometry study. Int Orthop 36(3):533CrossRefPubMedCentralPubMed

45.

Tingart M, Beckmann J, Opolka A, Matsuura M, Schaumburger J, Grifka J, Grassel S (2009) Analysis of bone matrix composition and trabecular microarchitecture of the femoral metaphysis in patients with osteonecrosis of the femoral head. J Orthop Res 27(9):1175CrossRefPubMed

46.

Koo KH, Dussault RG, Kaplan PA, Ahn IO, Kim R, Devine MJ, Cui Q, Cho SH, Wang GJ (1999) Fatty marrow conversion of the proximal femoral metaphysis in osteonecrotic hips. Clin Orthop Relat Res (361):159

47.

Braun A, Sabah A (2009) Two-year results of a modular short hip stem prosthesis–a prospective study. Z Orthop Unfall 147(6):700PubMed

48.

Meding JB, Galley MR, Ritter MA (2010) High survival of uncemented proximally porous-coated titanium alloy femoral stems in osteoporotic bone. Clin Orthop Relat Res 468(2):441CrossRefPubMedCentralPubMed

49.

Moritz N, Alm JJ, Lankinen P, Makinen TJ, Mattila K, Aro HT (2011) Quality of intertrochanteric cancellous bone as predictor of femoral stem RSA migration in cementless total hip arthroplasty. J Biomech 44(2):221CrossRefPubMed

50.

Gruen TA, McNeice GM, Amstutz HC (1979) “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res (141):17

51.

Floerkemeier T, Tscheuschner N, Calliess T, Ezechieli M, Floerkemeier S, Budde S, Windhagen H, von Lewinski G (2012) Cementless short stem hip arthroplasty METHA as an encouraging option in adults with osteonecrosis of the femoral head. Arch Orthop Trauma Surg 132(8):1125CrossRefPubMed

Title: Short-stem hip arthroplasty in osteonecrosis of the femoral head
Authors: Thilo Floerkemeier
Stefan Budde
Jens Gronewold
Kerstin Radtke
Max Ettinger
Henning Windhagen
Gabriela von Lewinski
Publication date: 01-05-2015
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 5/2015
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-015-2195-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Short-stem hip arthroplasty in osteonecrosis of the femoral head

Abstract

Introduction

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 5/2015

The Singh Index does not correlate with bone mineral density (BMD) measured with dual energy X-ray absorptiometry (DXA) or peripheral quantitative computed tomography (pQCT)

Retraction Note to: Total knee arthroplasty performed with either a mini-subvastus or a standard approach: a prospective randomized controlled study with a minimum follow-up of 2 years

No difference in clinical outcome, bone density and polyethylene wear 5–7 years after standard navigated vs. conventional cementfree total hip arthroplasty

Static progressive versus dynamic splinting for posttraumatic elbow stiffness: a systematic review of 232 patients

Posteroinferior shoulder instability: clinical outcome of arthroscopic stabilization in 32 shoulders and categorization based on labral mapping

Semiconstrained total elbow arthroplasty for rheumatoid arthritis patients: clinical and radiological results of 1–8 years follow-up