Nationwide multicenter follow-up cohort study of hip arthroplasties performed for osteonecrosis of the femoral head

International Orthopaedics
Seneki KobayashiNobuhiko Sugano

Abstract

To identify modifiable factors related to post-operative dislocation and reoperation in patients with osteonecrosis of the femoral head (ONFH) in a large cohort. We studied 4995 hip arthroplasties: total hip arthroplasty (THA) was performed in 79% of patients; bipolar hemiarthroplasty (BP), 17%; total resurfacing arthroplasty (tRS), 3%; and hemi-resurfacing arthroplasty (hRS), 1%. A new type of BP (accounting for 49% of BPs) comprised a femoral component with a polished or smooth, small-diameter (approximately 10 mm) neck with a round or oval axial cut surface and no sharp corners. The infection rate was relatively low (0.56%) even though 58% of cases of ONFH were associated with systemic steroid use, a known risk factor for infection. Post-operative dislocation occurred in 4.3% of cases, with re-operation needed in 3.9%. The dislocation rate was related to surgery type: 5.2% in THA, 0.9% in BP, and 0% in tRS and hRS. Among total arthroplasties with six month or longer follow-up (3670 THAs and 159 tRSs), the risk factors for post-operative dislocation were younger (≤ 40 years) or older (≥ 62 years) age, higher body weight, posterolateral approach, and smaller prosthetic head diameter. Regarding the need for re-operation, higher...Continue Reading

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Citations

Nov 6, 2018·SICOT-J·Philippe HernigouCharles Henri Flouzat Lachaniette
Aug 2, 2018·International Orthopaedics·Marius M ScarlatAndrew Quaile
Jun 24, 2018·International Orthopaedics·Philippe HernigouJacques Hernigou
Feb 20, 2020·Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs·Kazuma TakashimaNobuhiko Sugano
Sep 24, 2020·Evidence-based Complementary and Alternative Medicine : ECAM·Fanyu FuWeiheng Chen

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