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Aim: We show the short term results of cementless THA in patients younger than fifty years old who were suffering from avascular necrosis of the femoral head.
Materials Methods: From 09/1997 to 04/2002 we have treated 21 young patients (7 males and 14 females), aged from 24 to 50 years (mean: 37 y) and 27 hip (6 bilateral and 15 unilateral) suffering from AN, with cementless THA. Preoperatively all patients were assessed clinically for their function with D Aubigne Postel scoring system and we also assessed joint destruction and femoral head subsideness with radiographs and MRI respectively. All hips were III or IV Ficat stage and probably there was severe pain and limitation of joint functionality. We used a porous coated component for the acetabulum (Duraloc) and a partially coated cementless femoral stem with distal fixation (AML).
Results: We had no early or late infections, no dislocations and no nerve palsies. 2 patients had persistent thigh pain who has subsided a year after operation. At last follow up (88 30 months, mean: 48 m) we evaluate clinically and radiologically all patients using DAubigne Postel score and radiographs. We had 25 hips (93%) with excellent or good results and 2 hips in two different cases of bilateral replacements with fair or poor result. No evidence of radiological looseness of the components was found. All patients were very satisfied with their function in regard to previous condition and most of them returned to their normal life.
Conclusion: Cementless total hip replacements show excellent short term results in young patients with final stage avascular necrosis thought we need longer follow-up to come in to definite conclusions.