Abstract

To investigate the clinical outcome for the treatment of osteonecrosis of the femoral head (ONFH) in advanced stage by a short-stem prosthesis preserving femoral neck in total hip arthroplasty (THA). From June 2008 to December 2009, 9 hips in 8 patients with advanced stage of ONFH were treated by a short-stem preserving femoral neck in THA. The mean age was 24.1 years (range: 20 - 36). There were 3 patients (3 hips) with alcohol-induced ONFH and 5 patients (6 hips) with steroid-induced ONFH. According to the classification of Association Research Circulation Osseous (ARCO), 7 hips were in stage III-C and 2 hips in stage IV respectively. The clinical outcomes were evaluated according to the Harris evaluation score and radiographic analysis. All patients were followed up for a mean duration of 18.1 months (range: 12 - 30). The mean Harris hip score improved from preoperative (42.8 ± 8.6) points to (92.8 ± 6.1) points at the time of final follow-up. The outcomes were excellent in 7 hips and better in 2 hips. Neither osteolysis of mortar and femur nor loose component was found from radiological films. The pain of all hips disappeared and no complications occurred. The short-term clinical outcome is satisfactory for treating young patients with advanced stage of ONFH by a short-stem prosthesis preserving femoral neck in THA.

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