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International Orthopaedics

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01-07-2018 | Original Paper

Nationwide multicenter follow-up cohort study of hip arthroplasties performed for osteonecrosis of the femoral head

Authors: Seneki Kobayashi, Toshikazu Kubo, Yukihide Iwamoto, Wakaba Fukushima, Nobuhiko Sugano

Published in: International Orthopaedics | Issue 7/2018

Abstract

Purpose

To identify modifiable factors related to post-operative dislocation and reoperation in patients with osteonecrosis of the femoral head (ONFH) in a large cohort.

Methods

We studied 4995 hip arthroplasties: total hip arthroplasty (THA) was performed in 79% of patients; bipolar hemiarthroplasty (BP), 17%; total resurfacing arthroplasty (tRS), 3%; and hemi-resurfacing arthroplasty (hRS), 1%. A new type of BP (accounting for 49% of BPs) comprised a femoral component with a polished or smooth, small-diameter (approximately 10 mm) neck with a round or oval axial cut surface and no sharp corners.

Results

The infection rate was relatively low (0.56%) even though 58% of cases of ONFH were associated with systemic steroid use, a known risk factor for infection. Post-operative dislocation occurred in 4.3% of cases, with re-operation needed in 3.9%. The dislocation rate was related to surgery type: 5.2% in THA, 0.9% in BP, and 0% in tRS and hRS. Among total arthroplasties with six month or longer follow-up (3670 THAs and 159 tRSs), the risk factors for post-operative dislocation were younger (≤ 40 years) or older (≥ 62 years) age, higher body weight, posterolateral approach, and smaller prosthetic head diameter. Regarding the need for re-operation, higher body weight and surgery type were identified as risk factors.

Conclusions

The relatively high dislocation rate of 5.2% in THA is a cause for concern. The identified risk factors for dislocation should be considered when selecting THA for treatment. Prosthesis survivorship in hRSs was inferior to that in BPs or THAs. Body weight also affected the survivorship of hip arthroplasties.

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Title: Nationwide multicenter follow-up cohort study of hip arthroplasties performed for osteonecrosis of the femoral head
Authors: Seneki Kobayashi
Toshikazu Kubo
Yukihide Iwamoto
Wakaba Fukushima
Nobuhiko Sugano
Publication date: 01-07-2018
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 7/2018
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-018-3980-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Nationwide multicenter follow-up cohort study of hip arthroplasties performed for osteonecrosis of the femoral head

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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