Background: Pelvic irradiation for a malignant tumor may cause
osteonecrosis of the acetabulum. The purpose of this study was to evaluate the
outcome of uncemented total hip arthroplasty in patients with a history of
pelvic irradiation for the treatment of prostate cancer.
Methods: We performed a retrospective review of the clinical records
and radiographs of fifty-eight patients (sixty-six hips) who had had radiation
therapy for prostate cancer and had subsequently undergone an elective primary
uncemented total hip arthroplasty at our institution. The mean age of the
patients at the time of the index operation was seventy-four years. The mean
duration of follow-up was 4.8 years (range, two to 7.5 years).
Results: At the time of the final follow-up, fifty-one patients
(fifty-eight hips) who were still living and had been followed for a minimum
of two years had a well-ingrown and functioning replacement. The mean Harris
hip score had significantly improved from 47 points preoperatively to 90
points at the time of the final follow-up (p < 0.05). The mean scores on
the physical and mental health measures of the Short Form-36 had also improved
significantly from 45.1 and 65.3 points, respectively, before the operation to
73.4 and 83.7 points postoperatively (p < 0.05 for both). There was no
aseptic loosening of either component in any of the hips. Two hips had
revision of the femoral component; one was revised because of a periprosthetic
fracture of the femur and the other because of subsidence of the femoral
Conclusions: Uncemented total hip arthroplasty can be a successful
option for the treatment of coxarthrosis in patients with a history of pelvic
irradiation for prostate cancer. Osseointegration of uncemented components
does not seem to be compromised in these patients in the short term.
Level of Evidence: Therapeutic Level IV. See Instructions
to Authors for a complete description of levels of evidence.