Young-Hoo Kim1, Jang-Won Park2. 1. The Joint Replacement Center, Seoul Metropolitan SeoNam Hospital, Seoul, Republic of Korea. 2. The Joint Replacement Center, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea.
Abstract
BACKGROUND: Long-term result of the ultra-short anatomic cementless stem in the patients with idiopathic or ethanol-induced osteonecrosis of the femoral head has not been assessed. The aim of this study is to evaluate the long-term clinical, radiographic, computed tomography scan, and dual-energy X-ray absorptiometry scanning results, and survivorship of this specific femoral stem in patients with idiopathic or ethanol-induced femoral head osteonecrosis. METHODS: Two hundred fifty-six patients (335 hips) with an average age of 49.8 years (range 20-63) were enrolled in the current study. All patients underwent dual-energy X-ray absorptiometry scanning of the acetabulum and proximal femur preoperatively and at final follow-up. Computed tomography scan was obtained in all patients at final follow-up. The mean follow-up was 14.7 years (range 13-16). RESULTS: At final follow-up, the average Harris hip score, Western Ontario and McMaster Universities Osteoarthritis Index score, and University of California, Los Angeles activity score were 94 points, 12 points, and 8 points, respectively. Four stems (1%) underwent revision for aseptic loosening. One acetabular component (0.3%) was revised for recurrent dislocation. No hip was revised for squeaking or clicking sound. Survivorship of the femoral stem was 99.0% (95% confidence interval 94-100) and that of the acetabular component was 99.4% (95% confidence interval 95-100) at 14.7 years. CONCLUSION: Ultra-short proximal loading anatomic uncemented femoral stems with ceramic-on-ceramic bearings have excellent survivorship free from aseptic loosening and good clinical results at long term. LEVEL OF EVIDENCE: Level IV.
BACKGROUND: Long-term result of the ultra-short anatomic cementless stem in the patients with idiopathic or ethanol-induced osteonecrosis of the femoral head has not been assessed. The aim of this study is to evaluate the long-term clinical, radiographic, computed tomography scan, and dual-energy X-ray absorptiometry scanning results, and survivorship of this specific femoral stem in patients with idiopathic or ethanol-induced femoral head osteonecrosis. METHODS: Two hundred fifty-six patients (335 hips) with an average age of 49.8 years (range 20-63) were enrolled in the current study. All patients underwent dual-energy X-ray absorptiometry scanning of the acetabulum and proximal femur preoperatively and at final follow-up. Computed tomography scan was obtained in all patients at final follow-up. The mean follow-up was 14.7 years (range 13-16). RESULTS: At final follow-up, the average Harris hip score, Western Ontario and McMaster Universities Osteoarthritis Index score, and University of California, Los Angeles activity score were 94 points, 12 points, and 8 points, respectively. Four stems (1%) underwent revision for aseptic loosening. One acetabular component (0.3%) was revised for recurrent dislocation. No hip was revised for squeaking or clicking sound. Survivorship of the femoral stem was 99.0% (95% confidence interval 94-100) and that of the acetabular component was 99.4% (95% confidence interval 95-100) at 14.7 years. CONCLUSION: Ultra-short proximal loading anatomic uncemented femoral stems with ceramic-on-ceramic bearings have excellent survivorship free from aseptic loosening and good clinical results at long term. LEVEL OF EVIDENCE: Level IV.
Authors: Michael A Mont; Hytham S Salem; Nicolas S Piuzzi; Stuart B Goodman; Lynne C Jones Journal: J Bone Joint Surg Am Date: 2020-06-17 Impact factor: 6.558