Top

European Journal of Orthopaedic Surgery & Traumatology

Published in:

01-07-2020 | Osteoarthritis of the Hip | Original Article

Primary total hip replacement in Ficat–Arlet stage 3 and 4 osteonecrosis: a retrospective study at a minimum 12-year follow-up

Authors: Roger Erivan, Thomas Caputo, Hicham Riouach, Guillaume Villatte, Bruno Perreira, Stéphane Descamps, Stéphane Boisgard

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 5/2020

Abstract

Introduction

Results of total hip replacement (THR) for aseptic osteonecrosis are controversial and conflicting according to implant type and generation. The present study consisted in a retrospective assessment of implant survival in primary THR for aseptic osteonecrosis, using a cemented stem, standard polyethylene press-fit acetabular component, and metal–metal bearing. The study hypothesis was that THR results are equivalent between aseptic osteonecrosis and osteoarthritis of the hip.

Material and method

A single-center retrospective study included 54 patients with metal-on-metal THR for femoral head osteonecrosis. The main endpoint was revision surgery for all causes, whether implant related or procedure related; secondary endpoints were complications and progression in clinical scores.

Results

Mean follow-up was 13.9 ± 1.6 years (range 12.0–17.1 years). Eighteen of the 54 patients (33.3%) died. Implant survival at last follow-up was 93.8% (95% CI, 87.1–100). There were 12 complications (22.2%): 1 intraoperative, 5 (9.3%) immediate postoperative, and 6 (11.1%) long term. Clinical assessment found a significant 43.1 point improvement in mean Harris score (p = 8.4E−33) and a 5.6 point improvement in mean PMA score (p = 2.9E−22).

Conclusion

Survival in primary THR for aseptic osteonecrosis was good. Follow-up needs to be rigorous to screen for onset of complications. Primary THR is thus justified in Ficat–Arlet stage 3 and 4 aseptic osteonecrosis of the hip.

Level of evidence

IV.

Liu F, Wang W, Yang L et al (2017) An epidemiological study of etiology and clinical characteristics in patients with nontraumatic osteonecrosis of the femoral head. J Res Med Sci 22:15. https://doi.org/10.4103/1735-1995.200273 CrossRefPubMedPubMedCentral

Erivan R, Villatte G, Dartus J et al (2019) Progression and projection for hip surgery in France, 2008–2070: epidemiologic study with trend and projection analysis. Orthop Traumatol Surg Res. https://doi.org/10.1016/j.otsr.2019.07.021 CrossRefPubMed

Ficat P, Arlet J (1973) Pre-radiologic stage of femur head osteonecrosis: diagnostic and therapeutic possibilities. Rev Chir Orthop Reparatrice Appar Mot 59(Suppl 1):26–38

Colaço HB, Davidson JA, Davenport D et al (2018) Current practice of BHS members in the treatment of osteonecrosis of the femoral head in adults. Hip Int 28:90–95. https://doi.org/10.5301/hipint.5000535 CrossRefPubMed

Erivan R, Riouach H, Villatte G et al (2020) Hip preserving surgery for avascular hip necrosis: does terminating exposure to known risk factors improve survival? Phys Sportsmed. https://doi.org/10.1080/00913847.2020.1711827 CrossRefPubMed

Osawa Y, Seki T, Takegami Y et al (2018) Cementless total hip arthroplasty for osteonecrosis and osteoarthritis produce similar results at ten years follow-up when matched for age and gender. Int Orthop 42:1683–1688. https://doi.org/10.1007/s00264-018-3987-7 CrossRefPubMed

Ancelin D, Reina N, Cavaignac E et al (2016) Total hip arthroplasty survival in femoral head avascular necrosis versus primary hip osteoarthritis: case-control study with a mean 10-year follow-up after anatomical cementless metal-on-metal 28-mm replacement. Orthop Traumatol Surg Res 102:1029–1034. https://doi.org/10.1016/j.otsr.2016.08.021 CrossRefPubMed

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 14:21–28CrossRef

Issa K, Johnson AJ, Naziri Q et al (2014) Hip osteonecrosis: does prior hip surgery alter outcomes compared to an initial primary total hip arthroplasty? J Arthroplasty 29:162–166. https://doi.org/10.1016/j.arth.2013.04.028 CrossRefPubMed

10.

Johannson HR, Zywiel MG, Marker DR et al (2011) Osteonecrosis is not a predictor of poor outcomes in primary total hip arthroplasty: a systematic literature review. Int Orthop 35:465–473. https://doi.org/10.1007/s00264-010-0979-7 CrossRefPubMed

11.

Nich C, Rampal V, Vandenbussche E, Augereau B (2006) Metal-metal-backed polyethylene cemented hip arthroplasty: mid-term results. Rev Chir Orthop Reparatrice Appar Mot 92:118–124CrossRef

12.

Langton DJ, Jameson SS, Joyce TJ et al (2010) Early failure of metal-on-metal bearings in hip resurfacing and large-diameter total hip replacement: a consequence of excess wear. J Bone Joint Surg Br 92:38–46. https://doi.org/10.1302/0301-620X.92B1.22770 CrossRefPubMed

13.

Drummond J, Tran P, Fary C (2015) Metal-on-metal hip arthroplasty: a review of adverse reactions and patient management. J Funct Biomater 6:486–499. https://doi.org/10.3390/jfb6030486 CrossRefPubMedPubMedCentral

14.

Merle D’Aubigné R (1990) Numerical classification of the function of the hip. 1970. Rev Chir Orthop Reparatrice Appar Mot 76:371–374PubMed

15.

Johnston RC, Fitzgerald RH, Harris WH et al (1990) Clinical and radiographic evaluation of total hip replacement. A standard system of terminology for reporting results. J Bone Joint Surg Am 72:161–168CrossRef

16.

Devane PA, Horne JG, Martin K et al (1997) Three-dimensional polyethylene wear of a press-fit titanium prosthesis. Factors influencing generation of polyethylene debris. J Arthroplasty 12:256–266CrossRef

17.

Steinberg ME, Hayken GD, Steinberg DR (1995) A quantitative system for staging avascular necrosis. J Bone Joint Surg Br 77:34–41CrossRef

18.

Steinberg DR, Steinberg ME, Garino JP et al (2006) Determining lesion size in osteonecrosis of the femoral head. J Bone Joint Surg Am 88(Suppl 3):27–34. https://doi.org/10.2106/JBJS.F.00896 CrossRefPubMed

19.

Steinberg ME, Oh SC, Khoury V et al (2018) Lesion size measurement in femoral head necrosis. Int Orthop 42:1585–1591. https://doi.org/10.1007/s00264-018-3912-0 CrossRefPubMed

20.

Kerboul M, Thomine J, Postel M, Merle d’Aubigné R (1974) The conservative surgical treatment of idiopathic aseptic necrosis of the femoral head. J Bone Joint Surg Br 56:291–296CrossRef

21.

Koo KH, Kim R (1995) Quantifying the extent of osteonecrosis of the femoral head. A new method using MRI. J Bone Joint Surg Br 77:875–880CrossRef

22.

Statistical software & data analysis add-on for Excel | XLSTAT. In: Xlstat, Your data analysis solution. https://www.xlstat.com/en/. Accessed 4 Mar 2019

23.

Ryan SP, Wooster B, Jiranek W et al (2019) Outcomes of conversion total hip arthroplasty from free vascularized fibular grafting. J Arthroplasty 34:88–92. https://doi.org/10.1016/j.arth.2018.09.041 CrossRefPubMed

24.

Shigemura T, Yamamoto Y, Murata Y et al (2018) Total hip arthroplasty after failed transtrochanteric rotational osteotomy for osteonecrosis of the femoral head: a systematic review and meta-analysis. Orthop Traumatol Surg Res 104:1163–1170. https://doi.org/10.1016/j.otsr.2018.06.019 CrossRefPubMed

25.

Parker MJ, Cawley S (2020) Cemented or uncemented hemiarthroplasty for displaced intracapsular fractures of the hip: a randomized trial of 400 patients. Bone Joint J 102-B:11–16. https://doi.org/10.1302/0301-620X.102B1.BJJ-2019-1041.R1 CrossRefPubMed

26.

Erivan R, Villatte G, Lecointe T et al (2019) Long-term survival of hybrid total hip arthroplasty with the uncemented CLS cup, cemented Müller cobalt-chromium stem, and 28-mm Metasul™ bearings: retrospective review of 115 hips after a minimum of 17.8 years. Orthop Traumatol Surg Res. https://doi.org/10.1016/j.otsr.2019.06.019 CrossRefPubMed

27.

Cooper HJ, Della Valle CJ (2014) Large diameter femoral heads: is bigger always better? Bone Joint J 96-B:23–26. https://doi.org/10.1302/0301-620X.96B11.34342 CrossRefPubMed

28.

Suksathien Y, Sueajui J (2018) Mid-term results of short stem total hip arthroplasty in patients with osteonecrosis of the femoral head. Hip Int. https://doi.org/10.1177/1120700018816011 CrossRefPubMed

29.

Amstutz HC, Le Duff MJ (2018) The mean ten-year results of metal-on-metal hybrid hip resurfacing arthroplasty. Bone Joint J 100-B:1424–1433. https://doi.org/10.1302/0301-620X.100B11.BJJ-2017-1459.R2 CrossRefPubMed

30.

Erivan R, Villatte G, Brientini J-M et al (2018) 7-year results of primary total hip arthroplasty with the uncemented Avenir stem. HIP Int. https://doi.org/10.1177/1120700018810211 CrossRefPubMed

Title: Primary total hip replacement in Ficat–Arlet stage 3 and 4 osteonecrosis: a retrospective study at a minimum 12-year follow-up
Authors: Roger Erivan
Thomas Caputo
Hicham Riouach
Guillaume Villatte
Bruno Perreira
Stéphane Descamps
Stéphane Boisgard
Publication date: 01-07-2020
Publisher: Springer Paris
Keywords: Osteoarthritis of the Hip
Hip-TEP
Hip-TEP
Osteoarthritis of the Hip
Osteonecrosis
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 5/2020
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-020-02644-z

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Primary total hip replacement in Ficat–Arlet stage 3 and 4 osteonecrosis: a retrospective study at a minimum 12-year follow-up

Abstract

Introduction

Material and method

Results

Conclusion

Level of evidence

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction

Material and method

Results

Conclusion

Level of evidence

Please log in to get access to this content

Other articles of this Issue 5/2020

Percutaneous k-wire leverage reduction and retrograde transphyseal k-wire fixation of angulated radial neck fractures in children

Implant survival in uncemented total hip arthroplasty for displaced intracapsular femoral neck fractures: outcomes of 115 patients in a single center

Factors associated with positive outcomes of platelet-rich plasma therapy in Achilles tendinopathy

Uniplanar versus biplanar monolateral external fixator knee arthrodesis after end-stage failed infected total knee arthroplasty: a comparative study

Surgical repair of acute Achilles tendon ruptures: a follow-up of 639 consecutive cases

Graft choice for isolated MPFL reconstruction: gracilis versus semitendinosus