Total Hip Arthroplasty for Avascular Necrosis and Degenerative Osteoarthritis of the Hip

Xenakis, Theodoros; Beris, Alexandros E.; Malizos, K. K.; Koukoubis, Theodosios; Gelalis, John; Soucacos, Panayotis N.

doi:10.1097/00003086-199708000-00011

Cited by 49 publications

(19 citation statements)

References 15 publications

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“…Other studies evaluating more contemporary implant designs have had results comparable with those of the general population [7,14,38]. Ours is the first report of patients with ON treated with TMT cups and results are comparable with the results of TMT cups in patients with OA and second-generation cementless cups [7,14,38].…”

Section: Discussionsupporting

confidence: 63%

“…Although it is unclear whether it is attributable to bone quality, the underlining diagnosis, implants used, or the age of the patients with ON, results of THA in patients with ON are inferior when compared with results in the general population in some reports [2,3,31]. Other studies evaluating more contemporary implant designs have had results comparable with those of the general population [7,14,38]. Ours is the first report of patients with ON treated with TMT cups and results are comparable with the results of TMT cups in patients with OA and second-generation cementless cups [7,14,38].…”

Section: Discussionmentioning

confidence: 99%

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Survivorship of Monoblock Trabecular Metal Cups in Primary THA

Malizos

Bargiotas

Papatheodorou

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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Monoblock trabecular metal cups are made of a novel porous material intended to enhance ingrowth and improve fixation. We prospectively followed 223 consecutive patients with 245 trabecular metal acetabular cups implanted during primary total hip arthroplasties to determine the overall survivorship of the implant, and any association of survivorship to primary diagnosis and age, and to determine the fate of polar gaps and cysts. Minimum followup was 36 months (mean, 60 months; range, 36-112 months). Patients were assessed with the Harris Hip score and the Oxford questionnaire and radiographically with standardized serial radiographs. At last followup, all cups were radiographically stable with no evidence of migration or progressive radiolucencies. The survivorship with reoperation as the end point was estimated at 98.75% with a 95% confidence interval. Three reoperations occurred during the first 36 months. The Harris hip score increased from 48 to 94 and the Oxford score was 16.4 at the last examination. We observed no difference in terms of survivorship among patients with osteoarthritis, osteonecrosis, or hip dysplasia. Seven of 14 (50%) osteoarthritis cysts and 10 of 33 (33.3%) polar gaps detected on postoperative radiographs decreased or filled, whereas none of the remainder deteriorated with time. Our midterm results suggest this implant may enhance fixation, but long-term followup is needed to confirm our findings.

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Survivorship of Monoblock Trabecular Metal Cups in Primary THA

Malizos

Bargiotas

Papatheodorou

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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“…The social and economic cost associated with avascular necrosis of the femoral head can be significant for an individual [6] . Though, various treatment options have been tried in the past and few therapies are at current research stage (eg -Stem cell transplant), it is pertinent to state that definitive treatment of avascular necrosis of the femoral head is Total Hip Replacement as evidenced by empirical studies till date [7] . However, outcome of THR has been debated, much more in the past as studies had indicated higher need of revision surgeries [8] .…”

Section: Introductionmentioning

confidence: 99%

Study of clinical and functional outcome of total hip replacement in avascular necrosis of femoral head

Reddy¹,

Ms²,

Phad³

2018

Int. J. Orthop. Sci.

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Avascular necrosis (AVN) of the femoral head is one of the common causes of painful hip in a young adult. Since young age is associated with high functional demand AVN may have a devastating effect on the quality of life. The natural course of this disease is one of relentless progression with eventual collapse of the femoral head followed by secondary osteoarthritic changes in the hip. The management depends upon many factors including severity and location of necrotic lesion, patient factors and probability of collapse. Total hip replacement (THR) is needed in cases of collapse of femoral head, severe pain, osteoarthritis or destruction of hip joint. However there has been debate over whether THR is a viable option for AVN considering unique pathophysiology of AVN. Moreover the factors like functional outcome after surgery implant longevity and need for revision surgeries must be considered while doing total hip arthroplasty. In this context we conducted this prospective observational study to find out the clinical and functional outcomes of THR in patients with of AVN. Aims and Objectives: To study the clinical and functional outcome of total hip replacement in avascular necrosis of femoral head. Material and methods: Patients admitted to department of orthopedics in a tertiary care hospital in a metropolitan city with diagnosis of AVN were included in the study after taking into consideration a predefined inclusion and exclusion criteria for the study. Sample size of 30 was considered following statistical formula and admission registry of our hospital. Patients were recruited to the study after approval from institutional ethical committee and informed consent of patients. A detailed history was taken and thorough clinical examination was done in all patients. All patients were assessed with Harris hip score and points were allocated for each components of the score, which formed base line statistics for our study. Further patients were followed up at 6 weeks, 12 weeks and 24 weeks. Patients who could not turn up to the hospital were contacted over telephone and outcome was assessed through set of questionnaire based on Harris hip score. Result: The study consisted of 30 patients diagnosed to be having avascular necrosis of head of femur. Out of these 30 patients 23 were males and 7 patients were females with a M: F ratio of 1: 0.30. The most common age group affected was 21-40 years (43.33%) followed by 41-60 years (33.33%) and 61-80 years (23.33%). Majority of the patients with AVN had a body mass index between 25 to 29.99 (36.67%). Co-morbidities like diabetes or hypertension were seen in 11 (36.67%) patients. 9 (30%) patients were having history of either alcohol consumption or smoking. 13 patients had some predisposing factor for AVN in the form of either alcohol consumption, steroid therapy, history of trauma or pregnancy and rest of the patients were found to be having idiopathic AVN. The most common presenting complaints in the studied cases were found to be pain and difficulty in walking (9...

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“…In addition, several reports have indicated that BMSC isolation yield and osteogenic capacity are related to the risk factors of ONFH [6,9]. However, both patients with ONFH and patients without necrosis show similar levels of bone ingrowth into implants after arthroplasty [15,24], and no report has indicated that autologous bone graft healing rates are reduced in patients with ONFH. Moreover, there is evidence that active new bone formation occurs in femoral heads around necrotic areas in most patients with ONFH [4].…”

Section: Introductionmentioning

confidence: 99%

Osteogenic abilities of bone marrow stromal cells are not defective in patients with osteonecrosis

Yoo

Song²,

Koo

et al. 2008

International Orthopaedics (SICOT)

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We investigated whether the proliferation activities and osteogenic capacities of bone marrow stromal cells (BMSCs) are depressed in patients with osteonecrosis of the femoral head (ONFH). BMSCs were isolated from fresh bone marrow of the iliac crests of 54 donors and were differentiated into osteogenic lineage in vitro. The results of 27 consecutive patients with ONFH (16 idiopathic and 11 alcohol-induced) were compared with those of 27 patients with a nonnecrotic hip disorder. The proliferative activities of BMSCs in patients with ONFH were not found to be reduced and their osteogenic capacities (alkaline phosphatase activity and calcium deposition amount) were unaltered during in vitro differentiation. Results from patients with idiopathic or alcohol-induced ONFH were similar to those of matched patients with nonnecrotic disorder. These findings suggest that the osteogenic potentials of BMSCs are not defective in patients with ONFH.

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Total Hip Arthroplasty for Avascular Necrosis and Degenerative Osteoarthritis of the Hip

Cited by 49 publications

References 15 publications

Survivorship of Monoblock Trabecular Metal Cups in Primary THA

Survivorship of Monoblock Trabecular Metal Cups in Primary THA

Study of clinical and functional outcome of total hip replacement in avascular necrosis of femoral head

Osteogenic abilities of bone marrow stromal cells are not defective in patients with osteonecrosis

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