Background: The outcome of uncemented total hip arthroplasty in
patients with osteonecrosis of the femoral head in general, and in young
adults in particular, remains largely unknown. This study evaluated the
clinical and radiographic results of uncemented total hip arthroplasty in
young adults with osteonecrosis of the femoral head and compared these results
to those seen in young adults with osteoarthritis.
Methods: Forty-one consecutive patients with osteonecrosis of the
femoral head (fifty-two hips) and forty patients with osteoarthritis
(fifty-two hips) were treated with an uncemented total hip arthroplasty at our
institution. The mean age for the osteonecrosis group was thirty-eight years,
and, for the osteoarthritis group, forty-two years. Clinical and radiographic
outcomes at a minimum of two years were assessed.
Results: At a mean duration of follow-up of three years, the
functional improvement was significant in both groups (p < 0.05). The
outcome was good to excellent for 94% (forty-nine hips) in the osteonecrosis
group and 96% (fifty hips) in the osteoarthritis group. There were two
revisions in the osteonecrosis group and one revision in the osteoarthritis
group. Survivorship free of revision at the time of the latest follow-up was
96.1% for the osteonecrosis group and 98% for the osteoarthritis group.
Conclusions: The short-term results of cementless total hip
arthroplasty in patients with osteonecrosis of the femoral head were
encouraging and comparable with the results of a matched group of patients
with osteoarthritis. We await further follow-up to see if these promising
results hold true.
Level of Evidence: Therapeutic Level III. See
Instructions to Authors on
jbjs.org for a
complete description of levels of evidence.