Patients and methods

From 2003 January to 2009 January, there were 18 hips(18 patients) who underwent conversion THA from TRO for osteonecrosis of the femoral head (ONFH) (Group I). The mean duration from TRO to conversion THA was 2.6 years. We made a matched control group of 18 primary THA for ONFH (Group II) and we evaluated perioperative morbidity and complications in each group. For the clinical evaluation, we checked Harris hip score (HHS) and WOMAC score. For the radiographical evaluation, we evaluated implant position, stability and osteolysis.

Methods

Sixty-six hips (63 patients) that underwent revision THA using a metal-inlay polyethylene liner cementation were included. The causes of revision were; polyethylene wear in 37 cases, femoral stem loosening in 20 cases, ceramic head fracture in 4 cases, and recurrent dislocation in 5 cases. Clinical results were graded at final follow-up using Harris hip scores, and radiographs were evaluated to determine acetabular component inclination, the stabilities of acetabular and femoral components, correction of hip centers, and the progression of osteolysis.

Patients and Methods

19 consecutive patients (19 hips) with displaced femoral neck fracture with muscle weakness were enrolled. There were 11 patients with cerebral infarction, 4 patients with cerebral hemorrhage and 4 patients with Parkinson's disease. In the lateral position, an anterolateral approach between the gluteus medius and tensor fascia lata and a posterior approach between the piriformis and gluteus medius were used.

Surgical morbidity, functional recovery, radiological implantation properties, range of motion (ROM) and complications were assessed.

Methods

Twenty eight patients (35 hips) who underwent total hip arthroplasty with second generation metal-on-metal bearings for osteonecrosis of the femoral head at a minimum 5-year follow-up were included in this study. There were 5 women (6 hips) and 23 men (29 hips) who had a mean age of 40 years (range, 23 to 49 years) and a mean follow-up of 7 years. We used a Fitmore (Zimmer) cup and a 28mm Metasul femoral head in all cases. A CLS (Protek AG/Zimmer) femoral stem was used in 30 hips and a Cone prosthesis¯ (Protek AG) was used in 5 hips. Functional results were measured by Harris hip (HHS) and WOMAC scores. Radiographic evaluations were used to assess loosening and osteolysis according to Gruen and Delee and Charnley criteria.

Methods

From December 2007 to July 2008, 45 hips (33 patients) underwent total hip arthroplasty for the treatment of osteonecrosis of the femoral head. There was 1 woman (2 hips) and 32 men (43 hips) who had a mean age of 39 years (range, 22 to 64 years). The minimum follow-up was 12 months (range, 12 to 19 months). The authors modified the original minimally invasive two-incision total hip arthroplasty technique and used large-diameter metal-on-metal articulations. In the lateral position, an anterolateral approach was used between the gluteus medius and tensor fascia lata muscles and for the posterior approach the muscle plane was between the piriformis and gluteus medius muscles. The acetabular components, Durom¯ (Zimmer) in 20 hips and Magnum¯ (Biomet) was used in 25 hips. M/L taper¯ (Zimmer) femoral stems were used in all cases. The size of the femoral heads were 38 mm (1 hip), 40 mm (3 hips), 42 mm (13 hips), 44 mm (18 hips), 46 mm (5 hips), 48 mm (4 hips) and 50 mm (1 hip). Postures such as excessive flexion or adduction which cause dislocation were not restricted, post-operatively. Functional results were measured by Harris hip scores (HHS), WOMAC scores, and range of motion. Radiographic evaluation was assessed for positions of components and post-operative complications were noted.

Methods

Forty one patients (55 hips) who underwent total hip arthroplasty with third generation ceramic-on-ceramic bearings for osteonecrosis of the femoral head with a minimum 4-year follow-up were included in this study. There were 26 men and 15 women who had a mean age of 26 years (range, 16 to 29 years). The average duration of follow-up was 6 years (range, 4 to 7 years). All surgeries were done by a single hip surgeon and third generation ceramic-on-ceramic articulations were used. Securefit (Stryker) acetabular components were used in 46 hips and Duraloc (Depuy) in 9 hips. Accolade (Stryker) femoral stems were used in 33 hips, cone prosthesis (Zimmer) in 18 hips and CLS (Zimmer) in 4 hips. Functional results were measured by Harris hip (HHS) and WOMAC scores. Radiographic evaluation was assessed for loosening and osteolysis according to Gruen and Delee and Charnley criteria.