Abstract
The experience of hip replacement in young patients with osteonecrosis of the femoral head was analyzed in the article. The results of operations in the osteonecrosis group and osteoarthritis group in 3 years and 7 months after operations were compared. In 97.5 % of cases, cementless fixation implants with a ceramic on ceramic friction pair (45 %) and ceramic on polyethylene friction pair (45 %) were used. Surgical approaches by Moore, Hardinge and AMIS technique were applied. The clinical results of operations in the studied groups were similar, but the survival rate of endoprostheses in the osteonecrosis group was 91.5 %, and in the osteoarthritis group 97.2 %. In the osteonecrosis group an increased frequency of complications (dislocation of the endoprosthesis head, periprosthetic fracture, periprosthetic infection) and revision operations were observed. Our results show the influence of risk factors, concomitant diseases, the level of activity of young patients on the long-term total hip arthroplasty result.
Highlights
Total hip arthroplasty (THA) is the method of choice for the treatment of late stages of femoral head necrosis (FHN) [1]
We conducted a comparative assessment of the THA results in operated patients in osteonecrosis and osteoarthritis groups
The treatment results were studied in patients in the osteonecrosis group and patients in the osteoarthritis group (Tab. 3)
Summary
Total hip arthroplasty (THA) is the method of choice for the treatment of late stages of femoral head necrosis (FHN) [1]. There are dislocations of the endoprosthesis head, periprosthetic fractures, periprosthetic infection among the complications [9] These all lead to an inevitable increase in the number of revision surgeries, which makes up 10–15 % of the number of initially THA annually, according to world statistics [10]. People of working age 25–55 years old were prevailed among patients with FHN in the study group. In 37 (92.5 %) patients before THA conservative treatment was the main method (Fig. 1); in 3 (7.5 %) cases, decompression of the necrosis focus with bone grafting was previously performed. In our work we used the ARCO classification of femoral head necrosis, taking into account the magnitude of the femoral head lesion and degree of its impression [15]
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