Cementless Total Hip Arthroplasty In The Treatment Of Patients With Late Stage Osteonecrosis Of The Femoral Head

ObjectiveTo retrospective study the curative effects of cementless total hip arthroplasty(THA) in the treatment of patients with late stage osteonecrosis of the femoral head(ONFH).MethodsThis study examined the results of cementless THA in patients with late stage osteonecrosis of the femoral head(ONFH).From January 2006 to January 2010,a series of 115 patients(129 hips) who had undergone THA with cementless components in our department were involved in this study. A totol of 93 patients(105 hips) were available for this review.Of them,male was 63 patients(72 hips) and female was 30 patients(33 hips).Their ages ranged from 21.0 to 74.0 years and a mean was 30.0 years.Their body mass index(BMI) ranged from 16.2 to 31.3 kg/m2 and a mean was 23.8 kg/m2.The underlying diagnosis was alcohol-induced in 37 patients(43 hips),steroid-induced in 12 patients(14 hips), post-traumatic in 21 patients(22 hips), idiopathic in 23 patients(26 hips), According to Association Research Circulation Osseous(ARCO) classifying,34 and 71 hips were in stage ARCO III-C and ARCO IV respectively.All patients were evaluated both clinically and radiographically. Clinical outcomes were evaluated according to Harris evaluation score.The operative condition and complication were observed. Components migration and bone changes around the components were measured in the anterior-posterior and lateral X-ray of the hips.ResultsIn this group,93 patients(105 hips) were obtained follow-up form 0.8 to 4.7 years with an average of 2.3 years.The Harris evaluation score of the function was increased to 93.2 points at post-operation from 44.0 points at pre-operation. The rate of excellent and good results was 96.2%(101/105).Some cases occurred complications,two cases were dislocation of the hip,2 cases were deep vein thrombosis,7 cases were pain of thigh,4 cases were heterotopic ossification,no wound infection and prosthesis infection,no important vascular and nerve damage,no prosthesis around fractures and no other complications. X-ray follow-up results is good.No component was seen to be loose radiographically or had been revised at the time of final follow-up.ConclusionThe cementless THA can be used to treat patients with late stage ONFH with satisfactory curative effects, and rare complications.