Short stem total hip arthroplasty for osteonecrosis of the femoral head in patients 60 years or younger: a 3- to 10-year follow-up study
Abstract Background In young patients with osteonecrosis of the femoral head (ONFH), short-stem total hip arthroplasty (THA) could allow a potential advantage in preserving metaphyseal bone-stock, when revision surgery might become necessary. However, only a few studies have evaluated the outcome of...
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| Format: | Article |
| Language: | English |
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BMC
2017-07-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12891-017-1662-6 |
| _version_ | 1819077645849067520 |
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| author | Antonio Capone Fabrizio Bienati Stefania Torchia Daniele Podda Giuseppe Marongiu |
| author_facet | Antonio Capone Fabrizio Bienati Stefania Torchia Daniele Podda Giuseppe Marongiu |
| author_sort | Antonio Capone |
| collection | DOAJ |
| description | Abstract Background In young patients with osteonecrosis of the femoral head (ONFH), short-stem total hip arthroplasty (THA) could allow a potential advantage in preserving metaphyseal bone-stock, when revision surgery might become necessary. However, only a few studies have evaluated the outcome of short-stem THAs in ONFH. We reviewed the prospectively collected data of a cementless partial neck-retaining short-stem with ceramic-on-ceramic bearings in ONFH patients. Methods Thirty patients (37 hips) younger than 60 years (mean age at surgery, 51.5 years) underwent THA with the NANOS® stem (Smith and Nephew, Marl, Germany) from January 2006 to December 2012. All patients received a 32-mm or 36 mm ceramic femoral head. Harris hip score, WOMAC and UCLA activity score were recorded. Postoperative radiographs were evaluated for bone-implant fixation and osteolysis. Further analysis correlated clinical findings with implants characteristics and patient demographics at mean 5.6 years’ follow-up (range, 3–10 years). Results The clinical and functional results improved significantly (p < 0.001). At latest follow-up, mean HHS, WOMAC, and UCLA activity scores were 90 (range, 71–100), 94 (range, 76–100), and 6.3 (range, 4–10) points, respectively. The diameter of the femoral head did not influence the clinical outcome (p = 0.661). All hips showed bone ingrowth fixation of the acetabular and femoral components. No patients showed osteolysis. No revision for any reason was performed during the study period. Conclusions The excellent clinical results and fixation pattern at mean 5.6 years’ follow-up reveal this implant as a reliable option in advanced stage of ONFH either. Further investigations are crucial to determine the long-term durability and to assess whether the association of ceramic-on-ceramic bearings, can be useful to achieve longer survivorship and lower complications rates. Trial registration Registry number: ISRCTN 91336248 ; date of registration: 04/07/2017. |
| first_indexed | 2024-12-21T19:00:30Z |
| format | Article |
| id | doaj.art-4e6a306af2a043cc971284544e729f01 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-21T19:00:30Z |
| publishDate | 2017-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-4e6a306af2a043cc971284544e729f012022-12-21T18:53:29ZengBMCBMC Musculoskeletal Disorders1471-24742017-07-011811910.1186/s12891-017-1662-6Short stem total hip arthroplasty for osteonecrosis of the femoral head in patients 60 years or younger: a 3- to 10-year follow-up studyAntonio Capone0Fabrizio Bienati1Stefania Torchia2Daniele Podda3Giuseppe Marongiu4Orthopaedic Clinic of the Department of Surgical Science, University of CagliariOrthopaedic Clinic of the Department of Surgical Science, University of CagliariOrthopaedic Clinic of the Department of Surgical Science, University of CagliariTrauma and Orthopaedic Department, Ospedale Santissima TrinitàOrthopaedic Clinic of the Department of Surgical Science, University of CagliariAbstract Background In young patients with osteonecrosis of the femoral head (ONFH), short-stem total hip arthroplasty (THA) could allow a potential advantage in preserving metaphyseal bone-stock, when revision surgery might become necessary. However, only a few studies have evaluated the outcome of short-stem THAs in ONFH. We reviewed the prospectively collected data of a cementless partial neck-retaining short-stem with ceramic-on-ceramic bearings in ONFH patients. Methods Thirty patients (37 hips) younger than 60 years (mean age at surgery, 51.5 years) underwent THA with the NANOS® stem (Smith and Nephew, Marl, Germany) from January 2006 to December 2012. All patients received a 32-mm or 36 mm ceramic femoral head. Harris hip score, WOMAC and UCLA activity score were recorded. Postoperative radiographs were evaluated for bone-implant fixation and osteolysis. Further analysis correlated clinical findings with implants characteristics and patient demographics at mean 5.6 years’ follow-up (range, 3–10 years). Results The clinical and functional results improved significantly (p < 0.001). At latest follow-up, mean HHS, WOMAC, and UCLA activity scores were 90 (range, 71–100), 94 (range, 76–100), and 6.3 (range, 4–10) points, respectively. The diameter of the femoral head did not influence the clinical outcome (p = 0.661). All hips showed bone ingrowth fixation of the acetabular and femoral components. No patients showed osteolysis. No revision for any reason was performed during the study period. Conclusions The excellent clinical results and fixation pattern at mean 5.6 years’ follow-up reveal this implant as a reliable option in advanced stage of ONFH either. Further investigations are crucial to determine the long-term durability and to assess whether the association of ceramic-on-ceramic bearings, can be useful to achieve longer survivorship and lower complications rates. Trial registration Registry number: ISRCTN 91336248 ; date of registration: 04/07/2017.http://link.springer.com/article/10.1186/s12891-017-1662-6Osteonecrosis of the femoral headHip arthroplastyShort stemsCeramic on ceramic bearings |
| spellingShingle | Antonio Capone Fabrizio Bienati Stefania Torchia Daniele Podda Giuseppe Marongiu Short stem total hip arthroplasty for osteonecrosis of the femoral head in patients 60 years or younger: a 3- to 10-year follow-up study BMC Musculoskeletal Disorders Osteonecrosis of the femoral head Hip arthroplasty Short stems Ceramic on ceramic bearings |
| title | Short stem total hip arthroplasty for osteonecrosis of the femoral head in patients 60 years or younger: a 3- to 10-year follow-up study |
| title_full | Short stem total hip arthroplasty for osteonecrosis of the femoral head in patients 60 years or younger: a 3- to 10-year follow-up study |
| title_fullStr | Short stem total hip arthroplasty for osteonecrosis of the femoral head in patients 60 years or younger: a 3- to 10-year follow-up study |
| title_full_unstemmed | Short stem total hip arthroplasty for osteonecrosis of the femoral head in patients 60 years or younger: a 3- to 10-year follow-up study |
| title_short | Short stem total hip arthroplasty for osteonecrosis of the femoral head in patients 60 years or younger: a 3- to 10-year follow-up study |
| title_sort | short stem total hip arthroplasty for osteonecrosis of the femoral head in patients 60 years or younger a 3 to 10 year follow up study |
| topic | Osteonecrosis of the femoral head Hip arthroplasty Short stems Ceramic on ceramic bearings |
| url | http://link.springer.com/article/10.1186/s12891-017-1662-6 |
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