Total hip arthroplasties in patients less than forty-five years old.

“…The results of cemented THAs with metal-on-polyethylene articulation in ON have not generally been satisfactory in studies reported with a similar age group and followup as our mean 5.5 years [5,7,10,24,26,28]. One study [7] reported an overall failure rate of 37% at a mean followup of 7.6 years in 28 cemented arthroplasties; a second study [28] reported unsatisfactory results in 14 of 29 ON hips (48%) compared with 16 of 63 (25%) in patients with OA, and a third study [26] had a poor outcome in 11 of 12 cemented ON hips.…”

Section: Discussionmentioning

confidence: 54%

Metal-on-Metal Hip Arthroplasty Does Equally Well in Osteonecrosis and Osteoarthritis

Dastane

Long

Wan

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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Many previous reports suggest total hip arthroplasty performs suboptimally in young patients with osteonecrosis. We retrospectively compared the performance of metal-on-metal articulation in a select group of 107 patients with 112 hips (98 uncemented and 14 cemented stems) 60 years of age or younger with either osteonecrosis (27 patients, 30 hips) or primary osteoarthritis (80 patients, 82 hips). We evaluated all patients with patient-generated Harris hip score forms and serial radiographs. Five mechanical complications were caused by impingement, two with pain, two dislocations, and one liner dissociation. At a minimum followup of 2.2 years (mean, 5.5 years; range, 2.2-11.7 years), we observed no osteolysis or aseptic loosening in the osteonecrosis group, whereas one osteoarthritic hip had cup revision for loosening (none showed evidence of osteolysis). None of the stems were loose. Patients with osteonecrosis or primary osteoarthritis were similar in clinical and radiographic performance. The patients with metal-on-metal hip arthroplasty for osteonecrosis had no revisions for aseptic loosening, but did have one liner change in a cup for painful impingement.

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“…That similar loading mechanisms also increase the risk of THR revision has been demonstrated (Dorr et al 1983, Surin and Sundholm 1983, White 1988, Schurman et al 1989, Hozack et al 1990, Kilgus et al 1991, Karachalios et al 1993. Smoking, alcohol abuse and steroid medication are associated with an increased risk of osteonecrosis of the femoral head (Chang et a].…”

Section: A Population Register-based Case-control Study Of 674 Revisementioning

confidence: 85%