Skip to main content
SpringerLink
Log in

Hip Arthroplasty for Osteonecrosis of the Femoral Head

  • Chapter
  • First Online:
Osteonecrosis

  • 2087 Accesses

Abstract

The typical patient affected by osteonecrosis (ON) of the hip joint ranges in age from 20 to 50 years [1], and men are usually more prone to idiopathic ON than women [2]. Also, bilateral involvement is quite frequent [3–5]. Acute discomfort is felt by the patient when necrotic bone no longer performs its support function and a subchondral fracture or collapse occurs [6]. Accurate staging of the disease is essential to select the appropriate treatment option, and many surgical procedures exist for the treatment of ON of the femoral head. A treatment algorithm can be defined, which will take into consideration (1) the age of the patient, (2) the development stage of the disease, and (3) the clinical and survivorship results of various procedures available to the treating physician. Here, we can see that this treatment algorithm is not set in stone as the evolution of surgical techniques can alter outcomes, possibly reducing the usefulness of a procedure while expanding the indications for another. Several staging systems exist [7–10] and some may be preferred in the description of the early stages of the disease, but we believe that the Ficat and Arlet classification provides the essential information to treat patients who may be best treated with one type of hip arthroplasty [7].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Hungerford D. Treatment of ischemic necrosis of the femoral head. In: Evarts C, editor. Surgery of the musculoskeletal system. New York: Churchill Livingstone; 1983. p. 5.

    Google Scholar 

  2. Taylor L. Multifocal avascular necrosis after short-term high-dose steroid therapy. A report of three cases. J Bone Joint Surg Br. 1984;66(3):431–3.

    CAS  PubMed  Google Scholar 

  3. Ficat R. Treatment of avascular necrosis of the femoral head. Hip. 1983:279–95.

    Google Scholar 

  4. Hauzeur J, Pasteels J, Orloff S. Bilateral non-traumatic aseptic osteonecrosis in the femoral head. An experimental study of incidence. J Bone Joint Surg Am. 1987;69(8):1221–5.

    CAS  PubMed  Google Scholar 

  5. Merle D’Aubigné R, Postel M, Mazabraud A, Massias P, Gueguen J, France P. Idiopathic necrosis of the femoral head in adults. J Bone Joint Surg Br. 1965;47(4):612–33.

    PubMed  Google Scholar 

  6. Hedley A, Kim W. Prosthetic replacement in osteonecrosis of the hip. Instr Course Lect. 1983;32:265–71.

    CAS  PubMed  Google Scholar 

  7. Ficat R, Arlet J. Ischaemia and necrosis of bone. Baltimore: Williams & Watkins; 1980.

    Google Scholar 

  8. Ficat RP. Idiopathic bone necrosis of the femoral head. Early diagnosis and treatment. J Bone Joint Surg Br. 1985;67(1):3–9.

    CAS  PubMed  Google Scholar 

  9. Marcus N, Enneking W, Massam R. The silent hip in idiopathic aseptic necrosis. Treatment by bone-grafting. J Bone Joint Surg Am. 1973;55(7):1351–66.

    CAS  PubMed  Google Scholar 

  10. Steinberg M, Hayken G, Steinberg D. A new method for evaluating and staging of avascular necrosis of the femoral head. In: Arlet J, Ficat R, Hungerford D, editors. Proceedings of the third international symposium on circulation in bone, Toulouse, France. Baltimore: Williams & Watkins; 1982.

    Google Scholar 

  11. Rajagopal M, Balch Samora J, Ellis T. Efficacy of core decompression as treatment for osteonecrosis of the hip: a systematic review. Hip Int. 2012;22(5):489–93.

    Article  PubMed  Google Scholar 

  12. Bozic K, Zurakowski D, Thornhill T. Survivorship analysis of hips treated with core decompression for nontraumatic osteonecrosis of the femoral head. J Bone Joint Surg Am. 1999;81(2):200–9.

    CAS  PubMed  Google Scholar 

  13. Lavernia C, Sierra R. Core decompression in atraumatic osteonecrosis of the hip. J Arthroplasty. 2000;15(2):171–8.

    Article  CAS  PubMed  Google Scholar 

  14. Marker D, Seyler T, Ulrich S, Srivastava S, Mont M. Do modern techniques improve core decompression outcomes for hip osteonecrosis? Clin Orthop Relat Res. 2008;466(5):1093–103.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Urbaniak JR, Coogan PG, Gunneson EB, Nunley JA. Treatment of osteonecrosis of the femoral head with free vascularized fibular grafting. J Bone Joint Surg Am. 1995;77A(5):681–94.

    Google Scholar 

  16. Sotereanos D, Plakseychuk A, Rubash H. Free vascularized fibula grafting for the treatment of osteonecrosis of the femoral head. Clin Orthop Relat Res. 1997;344:243–56.

    Article  PubMed  Google Scholar 

  17. Beaulé PE, Amstutz HC. Management of ficat stage III and IV osteonecrosis of the hip. J Am Acad Orthop Surg. 2004;12:96–105.

    PubMed  Google Scholar 

  18. Marciniak D, Furey C, Shaffer J. Osteonecrosis of the femoral head. A study of 101 hips treated with vascularized fibular grafting. J Bone Joint Surg Am. 2005;87(4):742–7.

    Article  PubMed  Google Scholar 

  19. Aluisio F, Urbaniak J. Proximal femur fractures after free vascularized fibular grafting to the hip. Clin Orthop Relat Res. 1998;356:192–201.

    Article  PubMed  Google Scholar 

  20. Davis E, McKee M, Waddell J, Hupel T, Schemitsch E. Total hip arthroplasty following failure of free vascularized fibular graft. J Bone Joint Surg Am. 2006;88 Suppl 3:110–5.

    Article  PubMed  Google Scholar 

  21. Beaulé P, Le Duff M, Amstutz H. Hemiresurfacing arthroplasty of the hip for failed free-vascularized fibular graft. J Arthroplasty. 2003;18(6):519–23.

    Article  PubMed  Google Scholar 

  22. Eward W, Rineer C, Urbaniak J, Richard M, Ruch D. The vascularized fibular graft in precollapse osteonecrosis: is long-term hip preservation possible? Clin Orthop Relat Res. 2012;470(10):2819–26.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Veillette C, Mehdian H, Schemitsch E, McKee M. Survivorship analysis and radiographic outcome following tantalum rod insertion for osteonecrosis of the femoral head. J Bone Joint Surg Am. 2006;88 Suppl 3:48–55.

    Article  PubMed  Google Scholar 

  24. Shuler M, Rooks M, Roberson J. Porous tantalum implant in early osteonecrosis of the hip: preliminary report on operative, survival, and outcomes results. J Arthroplasty. 2007;22(1):26–31.

    Article  PubMed  Google Scholar 

  25. Tsao A, Roberson J, Christie M, Dore D, Heck D, Robertson D, et al. Biomechanical and clinical evaluations of a porous tantalum implant for the treatment of early-stage osteonecrosis. J Bone Joint Surg Am. 2005;87 Suppl 2:22–7.

    Article  PubMed  Google Scholar 

  26. Floerkemeier T, Thorey F, Daentzer D, Lerch M, Klages P, Windhagen H, et al. Clinical and radiological outcome of the treatment of osteonecrosis of the femoral head using the osteonecrosis intervention implant. Int Orthop. 2011;35(4):489–95.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Fung D, Frey S, Menkowitz M, Mark A. Subtrochanteric fracture in a patient with trabecular metal osteonecrosis intervention implant. Orthopedics. 2008;31(6):614.

    Article  PubMed  Google Scholar 

  28. Stronach B, Duke J, Rozensweig S, Stewart R. Subtrochanteric femur fracture after core decompression and placement of a tantalum strut for osteonecrosis of the femoral head. J Arthroplasty. 2010;25(7):1168.e5–7.

    Article  Google Scholar 

  29. Zimmer I. Trabecular metal osteonecrosis intervention implant-removal instruments – surgical technique. 2007. Accessed 31 Jan 13.

    Google Scholar 

  30. Owens J, Ely E, Guilliani N, Suarez J, Patel P. Removal of trabecular metal osteonecrosis intervention implant and conversion to primary total hip arthroplasty. J Arthroplasty. 2012;27(6):1251–3.

    Article  PubMed  Google Scholar 

  31. Mont M, Einhorn T, Sponseller P, Hungerford D. The trapdoor procedure using autogenous cortical and cancellous bone grafts for osteonecrosis of the femoral head. J Bone Joint Surg Br. 1998;80-B(1):56–62.

    Article  Google Scholar 

  32. Rosenwasser M, Garino J, Kiernan H, Michelsen C. Long term followup of thorough debridement and cancellous bone grafting of the femoral head for avascular necrosis. Clin Orthop Relat Res. 1994;306:17–27.

    PubMed  Google Scholar 

  33. Yuhan C, Hu C, Chen D, Ueng S, Shih C, Lee M. Local cancellous bone grafting for osteonecrosis of the femoral head. Surg Innov. 2009;16(1):63–7.

    Article  Google Scholar 

  34. Mont M, Etienne G, Ragland P. Outcome of nonvascularized bone grafting for osteonecrosis of the femoral head. Clin Orthop Relat Res. 2003;417:84–92.

    PubMed  Google Scholar 

  35. Amstutz HC, Dorey F, O’Carroll PF. THARIES resurfacing arthroplasty. Evolution and long-term results. Clin Orthop. 1986;213:92–114.

    PubMed  Google Scholar 

  36. Ortiguera C, Pulliam I, Cabanela M. Total hip arthroplasty for osteonecrosis. Matched-pair analysis of 188 hips with long-term follow-up. J Arthroplasty. 1999;14(1):21–8.

    Article  CAS  PubMed  Google Scholar 

  37. Schmalzried TP, Noordin S, Zahiri CA, Sarkany A, Campbell PA, Amstutz HC, editors. The critical difference in hemi-surface replacement vs. total hip resurfacing: absence of a polyethylene acetabular component. 44th annual meeting of the Orthopaedic Research Society, New Orleans, 16–19 Mar 1998.

    Google Scholar 

  38. Beaulé P, Schmalzried T, Campbell P, Dorey F, Amstutz H. Duration of symptoms and outcome of hemiresurfacing for hip osteonecrosis. Clin Orthop. 2001;385:104–17.

    Article  PubMed  Google Scholar 

  39. Amstutz H, Le Duff M. Current status of hemi-resurfacing arthroplasty for osteonecrosis of the hip. A 27-year experience. Orthop Clin North Am. 2009;40(2):275–82.

    Article  PubMed  Google Scholar 

  40. Beaulé P, Amstutz H. Hemiresurfacing arthroplasty for osteonecrosis of the hip. Oper Tech Orthop. 2000;10(2):123–32.

    Article  Google Scholar 

  41. Tooke SM, Amstutz HC, Delaunay C. Hemiresurfacing for femoral head osteonecrosis. J Arthroplasty. 1987;2(2):125–33.

    Article  CAS  PubMed  Google Scholar 

  42. Cuckler J, Moore K, Estrada L. Outcome of hemiresurfacing in osteonecrosis of the femoral head. Clin Orthop Relat Res. 2004;429:146–50.

    Article  PubMed  Google Scholar 

  43. Mont M, Seyler T, Marker D, Marulanda G, Delanois R. Use of metal-on-metal total hip resurfacing for the treatment of osteonecrosis of the femoral head. J Bone Joint Surg Am. 2006;88 Suppl 3:90–7.

    Article  PubMed  Google Scholar 

  44. Revell M, McBryde C, Bhatnagar S, Pynsent P, Treacy R. Metal-on-metal hip resurfacing in osteonecrosis of the femoral head. J Bone Joint Surg Am. 2006;88 Suppl 3:98–103.

    Article  PubMed  Google Scholar 

  45. Amstutz H, Le Duff M. Hip resurfacing results for osteonecrosis are as good as for other etiologies at 2- to 12-years. Clin Orthop. 2009;468(2):375–81.

    Article  PubMed Central  PubMed  Google Scholar 

  46. Le Duff M, Amstutz H, Dorey F. Metal-on-metal hip resurfacing for obese patients. J Bone Joint Surg Am. 2007;89(12):2705–11.

    Article  PubMed  Google Scholar 

  47. Sahlgrenska University Hospital DoO. The Swedish National Hip Arthroplasty Register – annual report 2010. http://www.shpr.se/en/Publications/DocumentsReportsaspx. 2010. p. 1–107.

  48. Cordingley R, Kohan L, Ben-Nissan B. What happens to femoral neck bone mineral density after hip resurfacing surgery? J Bone Joint Surg Br. 2010;92(12):1648–53.

    Article  CAS  PubMed  Google Scholar 

  49. Kishida Y, Sugano N, Nishii T, Miki H, Yamaguchi K, Yoshikawa H. Preservation of the bone mineral density of the femur after surface replacement of the hip. J Bone Joint Surg. 2004;86 B(3):185–9.

    Article  Google Scholar 

  50. Su E, Sheehan M, Su S. Comparison of bone removed during total hip arthroplasty with a resurfacing or conventional femoral component a cadaveric study. J Arthroplasty Suppl. 2010;25(2):325–9.

    Article  Google Scholar 

  51. Nakasone S, Takao M, Sakai T, Nishii T, Sugano N. Does the extent of osteonecrosis affect the survival of hip resurfacing? Clin Orthop Relat Res. 2013;471(6):1926–34.

    Article  PubMed Central  PubMed  Google Scholar 

  52. Sakagoshi D, Kabata T, Umemoto Y, Sakamoto J, Tomita K. A mechanical analysis of femoral resurfacing implantation for osteonecrosis of the femoral head. J Arthroplasty. 2010;25(8):1282–9.

    Article  PubMed  Google Scholar 

  53. Amstutz H, Le Duff M. Cementing the metaphyseal stem in metal-on-metal resurfacing: when and why. Clin Orthop. 2009;467(1):79–83.

    Article  PubMed Central  PubMed  Google Scholar 

  54. Madadi F, Eajazi A, Kazemi S, Aalami Harandi A, Madadi F, Sharifzadeh S. Total hip arthroplasty in advanced osteonecrosis: the short-term results by metal-on-metal hip resurfacing. Med Sci Monit. 2011;17(2):78–82.

    Article  Google Scholar 

  55. Australian Orthopaedic Association National Joint Replacement Registry [database on the Internet]. 2012. Available from: http://www.dmac.adelaide.edu.au/aoanjrr/documents/AnnualReports2011/AnnualReport_2011_WebVersion.pdf. Accessed 14 Feb 2013.

  56. Amstutz H, Le Duff M, Campbell P, Dorey F. The effects of technique changes on aseptic loosening of the femoral component in hip resurfacing. Results of 600 conserve plus with a 3–9 year follow-up. J Arthroplasty. 2007;22(4):481–9.

    Article  PubMed  Google Scholar 

  57. Aulakh T, Rao C, Kuiper J, Richardson J. Hip resurfacing and osteonecrosis: results from an independent hip resurfacing register. Arch Orthop Trauma Surg. 2010;130(7):841–5.

    Article  PubMed  Google Scholar 

  58. McMinn D, Daniel J, Pradhan C, Ziaee H. Avascular necrosis in the young patient: a trilogy of arthroplasty options. Orthopedics. 2005;28(9):945–7.

    PubMed  Google Scholar 

  59. Sayeed S, Johnson A, Stroh D, Gross T, Mont M. Hip resurfacing in patients who have osteonecrosis and are 25 years or under. Clin Orthop Relat Res. 2011;469(6):1582–8.

    Article  PubMed Central  PubMed  Google Scholar 

  60. Amstutz H, Le Duff M, Johnson A. Socket position determines hip resurfacing 10-year survivorship. Clin Orthop Relat Res. 2012;470(11):3127–33.

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Joint Replacement Institute at St Vincent Medical Center, 2200 West Third Street, Suite 400, Los Angeles, CA, 90057, USA

    Harlan C. Amstutz, Michel J. Le Duff & Mariam Al-Hamad

Authors
  1. Harlan C. Amstutz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michel J. Le Duff
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mariam Al-Hamad
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Harlan C. Amstutz .

Editor information

Editors and Affiliations

  1. Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Kyonggi-do, Korea, Republic of (South Korea)

    Kyung-Hoi Koo

  2. Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland, USA

    Michael A. Mont

  3. Department of Orthopaedic Surgery, Department of Orthopaedic Surgery, Center for Metabolism and Obesity Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

    Lynne C. Jones

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Amstutz, H.C., Le Duff, M.J., Al-Hamad, M. (2014). Hip Arthroplasty for Osteonecrosis of the Femoral Head. In: Koo, KH., Mont, M., Jones, L. (eds) Osteonecrosis. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-35767-1_51

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-35767-1_51

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-35766-4

  • Online ISBN: 978-3-642-35767-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation