The purpose of this study was to evaluate the functional and radiographical mid-term follow-up results of a second generation metal-on-metal cementless total hip arthroplasty for the treatment of osteonecrosis of the femoral head in patients younger than 50 years. 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.Introduction
Methods
The purpose of this study was to evaluate the functional and radiographical results in patients who underwent a modified minimally invasive two-incision total hip arthroplasty using large-diameter metal-on-metal articulations for osteonecrosis of the femoral head. 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.Introduction
Methods
The purpose of this study was to evaluate the functional and radiographical results in patients younger than 30 years who underwent cementless third generation ceramic-on-ceramic total hip arthroplasty for osteonecrosis of the femoral head. 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.Introduction
Methods