Abstract
BackgroundThe purpose of this study was to evaluate 10-year outcomes in cementless monobloc total hip arthroplasty (THA) in a group of hips with Legg-Calve-Perthes disease (LCPD).MethodsWe reviewed 71 patients (88 hips) who underwent cementless THA with a diagnosis of LCPD from 2003 to 2009. From the total of 71 patients, 34 men and 37 women with an average age of 49.94 years were included. The mean follow-up period was 10 years.ResultsThe mean Harris Hip Score improved significantly from 46.42 to 89.70. Similarly, the postoperative range of motion, hip dysfunction and osteoarthritis outcome score and SF-12 score also significantly improved. The mean leg lengthening was 22.1 mm. During the follow-up, eight complications were noted, including two cases of intraoperative femoral fractures, two cases of sciatic nerve paralysis, two cases of heterotrophic ossifications, one case of thigh pain and one case of dislocation. One revision was conducted for a periprosthetic fracture, and the survivorship at 10 years was 98.3%.ConclusionsThese data suggest that the monobloc stem can lead to satisfactory outcomes for clinical function, radiological evaluation, restoration of the normal limb lengths, complications, and survivorship among LCPD patients undergoing total hip arthroplasty.
Highlights
The purpose of this study was to evaluate 10-year outcomes in cementless monobloc total hip arthroplasty (THA) in a group of hips with Legg-Calve-Perthes disease (LCPD)
For the range of motion (ROM), the flexion improved from 90.13 ± 11.24° preoperatively to 120.32 ± 4.94°, and the abduction improved from 29.28 ± 5.50° preoperatively to 41.26 ± 3.73°
No cases with >10 mm of Limb length discrepancy (LLD) were identified, three slightly limp patients were noted by the final follow-up
Summary
The purpose of this study was to evaluate 10-year outcomes in cementless monobloc total hip arthroplasty (THA) in a group of hips with Legg-Calve-Perthes disease (LCPD). Legg-Calve-Perthes disease(LCPD) is characterized by osteonecrosis of the femoral head during childhood [1, 2]. THA for patients with LCPD is known to be technically demanding because of the flattens and widens of the femoral head, excessive anteversion of the femoral neck, a straight and narrow medullary canal of the femur, a. Monobloc cementless stems for patients with a history of Perthes’ disease raises several concerns: an increased risk of intraoperative femoral fracture, excessive anteversion of the femoral stem, malposition of the acetabular component, an increased risk of dislocation, unsatisfactory clinical and radiological results, and poor survivorship [5]
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