This study was undertaken to assess the result of total hip arthroplasty (THA) performed for fused hips. Twenty nine patients (31 hips), aged 21 to 70 years (average 46 years), underwent THA conversion surgery and were followed for an average of 4.6 years (2.4-12.0 years). There were 23 cases of spontaneous fusion and 8 case of surgical fusion. The causes of joint fusion were tuberculosis in 6 hips, childhood coxitis in 13, ankylosing spondylitis in 6 and childhood trauma in 4. Modified two incision technique was used in 9 hips and in 22 hips, the surgery was performed through a posterolateral approach combined with anterior capsulotomy through gluteus medius and tensor fasica lata interval. In 1 case, greater trochanter osteotomy was done. All acetabular components were inserted at the true acetabulum and the articulations were metal on metal in 7 cases and ceramic on ceramic in 24 cases. Postoperatively, range of motion exercises were encouraged after 2 to 3 weeks of bed rest and subsequent weight bearing crutch ambulation. Then active exercises were strongly encouraged to stretch abductors. We evaluated the clinical and radiological results.Purpose
Patients and Methods
The purpose of this study is to evaluate the functional and radiographical results in patients younger than 30 years who underwent cementless third generation ceramic-on-ceramic total hip arthroplasty (THA) for avascular necrosis (AVN) of femoral head. Forty one patients (55 hips) with a minimum 4-year follow-up were included in this study. There were 26 men and 15 women with a mean age of 25.6 years (range, 16 to 29 years). The average duration of follow-up was 5.7 years (range, 4.0 to 6.5 years). All surgeries were done by a single hip surgeon and third generation ceramic-on-ceramic articulation was used. Functional results were measured by Harris hip score (HHS) and WOMAC score. Radiographic evaluation was assessed for loosening and osteolysis according to Gruen's and Delee and Charnley's criteria.Purpose
Materials and Methods
The authors modified the original minimally invasive (MI) two-incision total hip arthroplasty (THA) technique and used large-diameter (32mm, 36mm) ceramic-on-ceramic articulation. One hundred and seventy patients that underwent unilateral MI two-incision THA retrospectively reviewed, and surgical morbidities, functional recoveries, radiological implantation properties, and complications were assessed. The mean follow-up was 30.2 months (range, 24-42 months) and mean patient age was 50.4 years (range, 22-83 years). 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 was used. Mean operation time was 71.2 minutes (range, 48-91 minutes). Mean Harris hip score improved from 41.8 (range, 10-59) to 96.1 (range, 73-100) at last follow-up, and mean WOMAC score from 66.2 (range, 49-96) to 26.9 (range, 24-39). The mean lateral opening angle of the acetabular component was 38.2° (range, 32.1°-47.7°) and the mean stem position was valgus 1.9° (range, varus 2.3° to valgus 4.8°). One patient suffered an intraoperative femur fracture and another underwent revision surgery due to stem subsidence. No patient experienced dislocation. Our data suggest the this modified technique is safe and reproducible in terms of achieving proper implant positioning and early functional recovery. In particular, the complication rates encountered, especially the dislocation rate, were low.
