Skip to main content

Advertisement

Log in

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

  • Original Article
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

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.

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

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. 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

    Google Scholar 

  2. Cabanela ME (1991) The bipolar prosthesis in avascular necrosis of the femoral head. Semin Arthroplasty 2:228–233

    CAS  PubMed  Google Scholar 

  3. 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 12:683–688

    CAS  PubMed  Google Scholar 

  4. Chmell SJ, Schwartz CM, Giacchino JL, Ing TS (1983) Total hip replacement in patients with renal transplants. Arch Surg 118:489–495

    CAS  PubMed  Google Scholar 

  5. Coombs RR, Thomas RW (1994) Avascular necrosis of the hip. Br J Hosp Med 51:275–280

    CAS  PubMed  Google Scholar 

  6. 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 344:124–138

    Article  PubMed  Google Scholar 

  7. Fink B, Ruther W (2000) Partial and total joint replacement in femur head necrosis (in German). Orthopäde 29:449–456

    Google Scholar 

  8. 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 334:108–115

    Article  PubMed  Google Scholar 

  9. Gonzalez MH, Ortinau ET, Buonanno W, Prieto J (1997) Cementless total hip arthroplasty in patients with advanced avascular necrosis. J South Orthop Assoc 6:162–168

    CAS  PubMed  Google Scholar 

  10. 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 2:5–9

    CAS  PubMed  Google Scholar 

  11. Hanker GJ, Amstutz HC (1988) Osteonecrosis of the hip in the sickle-cell diseases. Treatment and complications. J Bone Joint Surg Am 70:499–506

    CAS  PubMed  Google Scholar 

  12. Ito H, Matsuno T, Kaneda K (2000) Bipolar hemiarthroplasty for osteonecrosis of the femoral head. A 7- to-18-year follow-up. Clin Orthop 374:201–211

    Article  PubMed  Google Scholar 

  13. 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 78:14–19

    CAS  PubMed  Google Scholar 

  14. Lachiewicz PF, Desman SM (1988) The bipolar endoprosthesis in avascular necrosis of the femoral head. J Arthroplasty 3:131–138

    CAS  PubMed  Google Scholar 

  15. Lin E, Neurobay J, Katzenelson A (1983) Avascular necrosis of bone in decompression sickness. Harefuah 105:162–163

    CAS  PubMed  Google Scholar 

  16. Linde F, Andersen E, Hvass I, Madsen F, Pallesen R (1986) Avascular femoral head necrosis following fracture fixation. Injury 17:159–163

    CAS  PubMed  Google Scholar 

  17. 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 12:223–229

    Article  CAS  PubMed  Google Scholar 

  18. Mirzai R, Chang C, Greenspan A, Gershwin ME (1999) The pathogenesis of osteonecrosis and the relationships to corticosteroids. J Asthma 36:77–95

    CAS  PubMed  Google Scholar 

  19. 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 14:21–28

    CAS  PubMed  Google Scholar 

  20. Rombouts JJ (1999) Etiological factors of avascular necrosis of the femoral head. Twenty years later. Acta Orthop Belg 65 [Suppl 1]:3–4

    Google Scholar 

  21. 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 27:527–532

    PubMed  Google Scholar 

  22. Thompson GH, Salter RB (1980) Osteonecrosis of the femoral head during pregnancy. JAMA 244:689

    PubMed  Google Scholar 

  23. Thompson GH, Salter RB (1987) Legg-Calvé-Perthes disease. Current concepts and controversies. Orthop Clin North Am 18:617–635

    CAS  PubMed  Google Scholar 

  24. Vidigal EC Jr, Vidigal EC, Fernandes Jl (1997) Avascular necrosis as a complication of septic arthritis of the hip in children. Int Orthop 21:389–392

    Article  PubMed  Google Scholar 

  25. 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

    CAS  Google Scholar 

  26. Zangger P, Gladman DD, Urowitz MB, Bogoch ER (2000) Outcome of total hip replacement for avascular necrosis in systemic lupus erythematosus. J Rheumatol 27:919–923

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Israel Dudkiewicz.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dudkiewicz, I., Covo, A., Salai, M. et al. Total hip arthroplasty after avascular necrosis of the femoral head: does etiology affect the results?. Arch Orthop Trauma Surg 124, 82–85 (2004). https://doi.org/10.1007/s00402-003-0630-9

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-003-0630-9

Keywords

Navigation