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The purpose of this study was to evaluate the Mid-term results (minimum 5 year) of the use of 36 mm metallic femoral head coupled with 1st generation HXLPE in patients with the age of less than or equal to 50 years-old. This retrospective study included 31 cases sustained hip pain needed Total Hip Replace Arthroplasty. We used cementless stem(FMT, Zimmer, Warsaw, Indiana) at 28 cases and cement stem(Versys, Zimmer, Warsaw, Indiana) at 3 cases. We used Trilogy (Zimmer, Warsaw, Indiana) in all cases as an acetabular cup and Longevity (Zimmer, Warsaw, Indiana) in all cases as a HXLPE. Mean acetabular cup size was 52.88mm. Mean HXLPE liner thickness at 45o was 6.18mm [Fig.1]. Mean Harris hip score was 91(86–96) and all cases obtained more than 15 scores in Merle d'Aubigne and postel method at recent follow ups. All femoral stem showed stable fixation status. Mean acetabular cup Inclination was 50.6o and Anteversion was 23.1o. During follow ups, there was no complication including dislocation, osteolysis, infection and plastic fracture. Bedding-in wear rate was 0.079±0.034mm/yr. And Steady- state was 0.043±0.016mm/yr. In vitro study, 1stgeneration HXLPE showed negative mechanical property changes due to high dose radiation and remelting. So, concerns remained in using HXLPE to active patients. But we checked a good results in terms of functional scores and wear rates. And, there was no major complication during minimal 5 years check ups. So, the authors thought THRA with 36mm- metallic heads on 1st-Generation Highly Cross-linked Polyethylene as a bearing surface could be a good option in less than or equal to 50 years patients.


Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_I | Pages 137 - 137
1 Mar 2010
Kang J Park E Jung Y Cho M Song J Lee J Chang J Rhyu K
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Although the clinical manifestation of ONFH is well summarized as forms of various stages, its etiology, natural history or epidemiology has not been clearly elucidated yet. With this study, we wanted to find out the estimated annual incidence, epidemiologic characteristics and the effect of known risk factors of ONFH. Therefore we can understand the disease better to provide optimal management to the patients.

Among 133 189 patients who diagnosed as osteonecrosis of femoral head (ONFH) in database of national health insurance system in Korea from 2002 to 2006, three hundreds an eighty-two samples were randomly extracted with 5% error range in 95% confidence interval. With a structured worksheet, medical records and radiographs of each sample were reviewed at corresponding clinic or hospital by authors and trained orthopedic surgeons. With these data, we calculated the prevalence and associated risk factors.

The mean number of annual requests was 23 466. Among 382 samples, two hundreds and seventy-four were confirmed to have ONFH. Diagnostic accuracy was 71.7 %. Diagnosis was more accurate when the patient was male or hospitalized. After the logistic regression analysis, calculated diagnostic accuracy during 2002 and 2006 was 60.3% (51 823/85 987). The annual predicted number of cases of ONFH during this period was 14 103. It corresponds to 28.91 patients per 100 000 populations. Alcohol abuse was noted in 45% and 22% was related to use of steroid. 37% showed bilateral involvement. Bone graft procedures in any kind was the most frequently performed joint preserving procedure.

With this, the first epidemiologic study for ONFH in Korea, we estimated nationwide annual prevalence of ONFH as 28.91 per 100,000 populations during 2002 and 2006. There is an absolute male predominance. Alcohol abuse is the most frequent risk factors. We believe that this result can serve as a baseline data for understanding the epidemiology, clinical characteristics and treatment of ONFH.


Introduction: This paper describes the results of treatment of THA in irradiated hips, and analyzes the risk factors related to the early failure of the acetabular components.

Materials and Methods: Eighteen primary total hip arthroplasties (twelve patients) were analyzed. The mean follow-up period was fifty-eight months (range, twenty to 139 months). The acetabular components were of hemispherical design with an ingrowth surface of titanium fiber-metal in fourteen cases and roof rings in four cases. Risk factors were analyzed between age, total radiation dose, onset of symptoms after irradiation (≤ 4 years, > 4 years), and the risk of failure in the acetabular components after THA.

Results: When only nine cases of failure were considered, the interval from operation to failure had a positive association with total radiation dose and a negative association with the ages of the affected patients or the latent period before onset of symptoms. When all the cases were included in the survival analyses, the survival rates did not depend on either patient age or total radiation dose. The latent period was significantly related to the survival rate with a cutoff point of four years (p = 0.03). After age, total radiation dose, and component type were adjusted, the risk of failure was fifteen times higher (95% confidence interval: 1.03–227.44) in patients ≥ 4 years of the latent period, compared to those < 4 years of the latent period.

Conclusions: It is suggested that any arthroplasty other than a resection arthroplasty is unwise if the portal of irradiation includes the acetabulum and the latent period of the disease onset after irradiation is more than four years.