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European Journal of Orthopaedic Surgery & Traumatology

Erschienen in:

27.02.2020 | Original Article

Primary total hip replacement in Ficat–Arlet stage 3 and 4 osteonecrosis: a retrospective study at a minimum 12-year follow-up

verfasst von: Roger Erivan, Thomas Caputo, Hicham Riouach, Guillaume Villatte, Bruno Perreira, Stéphane Descamps, Stéphane Boisgard

Erschienen in: European Journal of Orthopaedic Surgery & Traumatology | Ausgabe 5/2020

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Abstract

Introduction

Results of total hip replacement (THR) for aseptic osteonecrosis are controversial and conflicting according to implant type and generation. The present study consisted in a retrospective assessment of implant survival in primary THR for aseptic osteonecrosis, using a cemented stem, standard polyethylene press-fit acetabular component, and metal–metal bearing. The study hypothesis was that THR results are equivalent between aseptic osteonecrosis and osteoarthritis of the hip.

Material and method

A single-center retrospective study included 54 patients with metal-on-metal THR for femoral head osteonecrosis. The main endpoint was revision surgery for all causes, whether implant related or procedure related; secondary endpoints were complications and progression in clinical scores.

Results

Mean follow-up was 13.9 ± 1.6 years (range 12.0–17.1 years). Eighteen of the 54 patients (33.3%) died. Implant survival at last follow-up was 93.8% (95% CI, 87.1–100). There were 12 complications (22.2%): 1 intraoperative, 5 (9.3%) immediate postoperative, and 6 (11.1%) long term. Clinical assessment found a significant 43.1 point improvement in mean Harris score (p = 8.4E−33) and a 5.6 point improvement in mean PMA score (p = 2.9E−22).

Conclusion

Survival in primary THR for aseptic osteonecrosis was good. Follow-up needs to be rigorous to screen for onset of complications. Primary THR is thus justified in Ficat–Arlet stage 3 and 4 aseptic osteonecrosis of the hip.

Level of evidence

IV.

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Titel: Primary total hip replacement in Ficat–Arlet stage 3 and 4 osteonecrosis: a retrospective study at a minimum 12-year follow-up
verfasst von: Roger Erivan
Thomas Caputo
Hicham Riouach
Guillaume Villatte
Bruno Perreira
Stéphane Descamps
Stéphane Boisgard
Publikationsdatum: 27.02.2020
Verlag: Springer Paris
Erschienen in: European Journal of Orthopaedic Surgery & Traumatology / Ausgabe 5/2020
Print ISSN: 1633-8065
Elektronische ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-020-02644-z

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Springer Medizin

Primary total hip replacement in Ficat–Arlet stage 3 and 4 osteonecrosis: a retrospective study at a minimum 12-year follow-up

Abstract

Introduction

Material and method

Results

Conclusion

Level of evidence

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Springer Medizin

Abstract

Introduction

Material and method

Results

Conclusion

Level of evidence

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