Femoral Head Osteonecrosis Treatment Methods   |    
Uncemented Total Hip Arthroplasty in Young Adults with Osteonecrosis of the Femoral Head: A Comparative Study
Michael A. Mont, MD; Thorsten M. Seyler, MD; Johannes F. Plate, BS; Ronald E. Delanois, MD; Javad Parvizi, MD
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Note: The authors thank Colleen Kazmarek and David Marker for their outstanding assistance in preparing this manuscript.
In support of their research for or preparation of this manuscript, one or more of the authors received grants or outside funding from Stryker Orthopaedics. In addition, one or more of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity (Stryker Orthopaedics). No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2006 Nov 01;88(suppl 3):104-109. doi: 10.2106/JBJS.F.00451
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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.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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