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Published in: Archives of Orthopaedic and Trauma Surgery 2/2004

01-03-2004 | Original Article

Total hip arthroplasty after avascular necrosis of the femoral head: does etiology affect the results?

Authors: Israel Dudkiewicz, Alon Covo, Moshe Salai, Amnon Israeli, Yehuda Amit, Aharon Chechik

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 2/2004

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Abstract

Introduction

The aim of the study was to evaluate the results of total hip arthroplasty (THA) due to avascular necrosis (AVN) of the femoral head and to establish whether the cause of AVN affects the results.

Material and methods

A group of 68 patients, 17–82 years of age (mean: 49.9 years) underwent 84 total hip arthroplasties due to AVN. The patients were divided into subgroups according to the etiology of AVN of the hip joint. The results of each group were evaluated by the Harris Hip score (HHS) at 3–18 years (mean: 6.2 years). The complication rate was also assessed.

Results

The mean preoperative HHS was 28.5±4.5 as opposed to a postoperative HHS of 86±10. The revision rate was 16.7%. Etiology does not affect the final outcome, but less favorable long-term results were found in the steroid-induced AVN patients.

Conclusions

Despite the previously reported, less favorable results, THA is a good option for the younger population, even with AVN, especially in bilateral disease. Etiology did not affect the final outcome. However, patients with steroid-induced AVN should be informed that although their final functional results will equal those of other groups, the longevity of the implants is limited.
Literature
1.
go back to reference Boyer DW, Mickelson MR, Ponseti IV (1981) Slipped capital femoral epiphysis. Long-term follow-up study of one hundred and twenty-one patients. J Bone Joint Surg Am 63:85–95 Boyer DW, Mickelson MR, Ponseti IV (1981) Slipped capital femoral epiphysis. Long-term follow-up study of one hundred and twenty-one patients. J Bone Joint Surg Am 63:85–95
2.
go back to reference Cabanela ME (1991) The bipolar prosthesis in avascular necrosis of the femoral head. Semin Arthroplasty 2:228–233PubMed Cabanela ME (1991) The bipolar prosthesis in avascular necrosis of the femoral head. Semin Arthroplasty 2:228–233PubMed
3.
go back to reference Chiu KH, Shen WY, Ko CK, Chan KM (1997) Osteonecrosis of the femoral head treated with cementless total hip arthroplasty. A comparison with other diagnoses. J Arthroplasty 12:683–688PubMed Chiu KH, Shen WY, Ko CK, Chan KM (1997) Osteonecrosis of the femoral head treated with cementless total hip arthroplasty. A comparison with other diagnoses. J Arthroplasty 12:683–688PubMed
4.
go back to reference Chmell SJ, Schwartz CM, Giacchino JL, Ing TS (1983) Total hip replacement in patients with renal transplants. Arch Surg 118:489–495PubMed Chmell SJ, Schwartz CM, Giacchino JL, Ing TS (1983) Total hip replacement in patients with renal transplants. Arch Surg 118:489–495PubMed
5.
go back to reference Coombs RR, Thomas RW (1994) Avascular necrosis of the hip. Br J Hosp Med 51:275–280PubMed Coombs RR, Thomas RW (1994) Avascular necrosis of the hip. Br J Hosp Med 51:275–280PubMed
6.
go back to reference D’Antonio JA, Capello WN, Manley MT, Feinberg J (1997) Hydroxyapatite coated implants. Total hip arthroplasty in the young patient and patients with avascular necrosis. Clin Orthop 344:124–138CrossRefPubMed D’Antonio JA, Capello WN, Manley MT, Feinberg J (1997) Hydroxyapatite coated implants. Total hip arthroplasty in the young patient and patients with avascular necrosis. Clin Orthop 344:124–138CrossRefPubMed
7.
go back to reference Fink B, Ruther W (2000) Partial and total joint replacement in femur head necrosis (in German). Orthopäde 29:449–456 Fink B, Ruther W (2000) Partial and total joint replacement in femur head necrosis (in German). Orthopäde 29:449–456
8.
go back to reference Garino JP, Steinberg ME (1997) Total hip arthroplasty in patients with avascular necrosis of the femoral head: a 2- to 10-year follow-up. Clin Orthop 334:108–115CrossRefPubMed Garino JP, Steinberg ME (1997) Total hip arthroplasty in patients with avascular necrosis of the femoral head: a 2- to 10-year follow-up. Clin Orthop 334:108–115CrossRefPubMed
9.
go back to reference Gonzalez MH, Ortinau ET, Buonanno W, Prieto J (1997) Cementless total hip arthroplasty in patients with advanced avascular necrosis. J South Orthop Assoc 6:162–168PubMed Gonzalez MH, Ortinau ET, Buonanno W, Prieto J (1997) Cementless total hip arthroplasty in patients with advanced avascular necrosis. J South Orthop Assoc 6:162–168PubMed
10.
go back to reference Gruen GS, Mears D, Tauxe WN (1988) Distinguishing avascular necrosis from segmental impaction of the femoral head following an acetabular fracture: preliminary report. J Orthop Trauma 2:5–9PubMed Gruen GS, Mears D, Tauxe WN (1988) Distinguishing avascular necrosis from segmental impaction of the femoral head following an acetabular fracture: preliminary report. J Orthop Trauma 2:5–9PubMed
11.
go back to reference Hanker GJ, Amstutz HC (1988) Osteonecrosis of the hip in the sickle-cell diseases. Treatment and complications. J Bone Joint Surg Am 70:499–506PubMed Hanker GJ, Amstutz HC (1988) Osteonecrosis of the hip in the sickle-cell diseases. Treatment and complications. J Bone Joint Surg Am 70:499–506PubMed
12.
go back to reference Ito H, Matsuno T, Kaneda K (2000) Bipolar hemiarthroplasty for osteonecrosis of the femoral head. A 7- to-18-year follow-up. Clin Orthop 374:201–211CrossRefPubMed Ito H, Matsuno T, Kaneda K (2000) Bipolar hemiarthroplasty for osteonecrosis of the femoral head. A 7- to-18-year follow-up. Clin Orthop 374:201–211CrossRefPubMed
13.
go back to reference Katz K, Horev G, Grunebaum M, Yosipovitch Z (1996) The natural history of osteonecrosis of the femoral head in children and adolescents who have Gaucher disease. J Bone Joint Surg Am 78:14–19PubMed Katz K, Horev G, Grunebaum M, Yosipovitch Z (1996) The natural history of osteonecrosis of the femoral head in children and adolescents who have Gaucher disease. J Bone Joint Surg Am 78:14–19PubMed
14.
go back to reference Lachiewicz PF, Desman SM (1988) The bipolar endoprosthesis in avascular necrosis of the femoral head. J Arthroplasty 3:131–138PubMed Lachiewicz PF, Desman SM (1988) The bipolar endoprosthesis in avascular necrosis of the femoral head. J Arthroplasty 3:131–138PubMed
15.
go back to reference Lin E, Neurobay J, Katzenelson A (1983) Avascular necrosis of bone in decompression sickness. Harefuah 105:162–163PubMed Lin E, Neurobay J, Katzenelson A (1983) Avascular necrosis of bone in decompression sickness. Harefuah 105:162–163PubMed
16.
go back to reference Linde F, Andersen E, Hvass I, Madsen F, Pallesen R (1986) Avascular femoral head necrosis following fracture fixation. Injury 17:159–163PubMed Linde F, Andersen E, Hvass I, Madsen F, Pallesen R (1986) Avascular femoral head necrosis following fracture fixation. Injury 17:159–163PubMed
17.
go back to reference McKee MD, Garay ME, Schmitsch EH, Kreder HJ, Stephen DJ (1998) Irreducible fracture dislocation of the hip: a severe injury with a poor prognosis. J Orthop Trauma 12:223–229CrossRefPubMed McKee MD, Garay ME, Schmitsch EH, Kreder HJ, Stephen DJ (1998) Irreducible fracture dislocation of the hip: a severe injury with a poor prognosis. J Orthop Trauma 12:223–229CrossRefPubMed
18.
go back to reference Mirzai R, Chang C, Greenspan A, Gershwin ME (1999) The pathogenesis of osteonecrosis and the relationships to corticosteroids. J Asthma 36:77–95PubMed Mirzai R, Chang C, Greenspan A, Gershwin ME (1999) The pathogenesis of osteonecrosis and the relationships to corticosteroids. J Asthma 36:77–95PubMed
19.
go back to reference 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 14:21–28PubMed 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 14:21–28PubMed
20.
go back to reference Rombouts JJ (1999) Etiological factors of avascular necrosis of the femoral head. Twenty years later. Acta Orthop Belg 65 [Suppl 1]:3–4 Rombouts JJ (1999) Etiological factors of avascular necrosis of the femoral head. Twenty years later. Acta Orthop Belg 65 [Suppl 1]:3–4
21.
go back to reference Rubinstein RA Jr, Beals RK (1993) The results of treatment of posttraumatic avascular necrosis of the femoral head in young adults: report of 31 patients. Contemp Orthop 27:527–532PubMed Rubinstein RA Jr, Beals RK (1993) The results of treatment of posttraumatic avascular necrosis of the femoral head in young adults: report of 31 patients. Contemp Orthop 27:527–532PubMed
22.
go back to reference Thompson GH, Salter RB (1980) Osteonecrosis of the femoral head during pregnancy. JAMA 244:689PubMed Thompson GH, Salter RB (1980) Osteonecrosis of the femoral head during pregnancy. JAMA 244:689PubMed
23.
go back to reference Thompson GH, Salter RB (1987) Legg-Calvé-Perthes disease. Current concepts and controversies. Orthop Clin North Am 18:617–635PubMed Thompson GH, Salter RB (1987) Legg-Calvé-Perthes disease. Current concepts and controversies. Orthop Clin North Am 18:617–635PubMed
24.
go back to reference Vidigal EC Jr, Vidigal EC, Fernandes Jl (1997) Avascular necrosis as a complication of septic arthritis of the hip in children. Int Orthop 21:389–392CrossRefPubMed Vidigal EC Jr, Vidigal EC, Fernandes Jl (1997) Avascular necrosis as a complication of septic arthritis of the hip in children. Int Orthop 21:389–392CrossRefPubMed
25.
go back to reference Ware HE, Brooks AP, Toye R, Berney SI (1991) Sickle cell disease and silent avascular necrosis of the hip. J Bone Joint Surg Am 73:947–949 Ware HE, Brooks AP, Toye R, Berney SI (1991) Sickle cell disease and silent avascular necrosis of the hip. J Bone Joint Surg Am 73:947–949
26.
go back to reference Zangger P, Gladman DD, Urowitz MB, Bogoch ER (2000) Outcome of total hip replacement for avascular necrosis in systemic lupus erythematosus. J Rheumatol 27:919–923PubMed Zangger P, Gladman DD, Urowitz MB, Bogoch ER (2000) Outcome of total hip replacement for avascular necrosis in systemic lupus erythematosus. J Rheumatol 27:919–923PubMed
Metadata
Title
Total hip arthroplasty after avascular necrosis of the femoral head: does etiology affect the results?
Authors
Israel Dudkiewicz
Alon Covo
Moshe Salai
Amnon Israeli
Yehuda Amit
Aharon Chechik
Publication date
01-03-2004
Publisher
Springer-Verlag
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 2/2004
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-003-0630-9

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