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Cementless Total Hip Arthroplasty with Alumina Bearings in Patients Younger Than Fifty with Femoral Head Osteonecrosis

¹ Department of Orthopaedic Surgery, Catholic University of Daegu Hospital, 3056-6 Dae-Myung-4, Nam-Gu, Daegu 705-718, South Korea. E-mail address: insideMe{at}paran.com
² Department of Orthopedic Surgery, Kyungpook National University Hospital, 50 Sam-Duk, Jung-Gu, Daegu 700-721, South Korea. E-mail address: syukim{at}knu.ac.kr
Investigation performed at the Department of Orthopedic Surgery, Kyungpook National University Hospital, Daegu, South Korea

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

Methods: We prospectively followed sixty patients (seventy-one hips) with a mean age of 39.1 years for an average of 7.1 years. All procedures were performed at the same institution by one surgeon, and the results were evaluated serially. The clinical evaluations included use of the Harris hip score, and activities of daily living were evaluated with use of the criteria of Johnston et al.

Results: The mean Harris hip score was 97.0 points at the time of final follow-up. Thirteen patients (fourteen hips, 20%) reported noise in the hip. Loosening or osteolysis was not observed in any hip, and no prosthesis had been revised. No hip had dislocated, and no ceramic fracture had occurred.

Conclusions: After a minimum of six years of follow-up, this cementless total hip arthroplasty with contemporary alumina bearings was found to be a promising procedure for young, active patients with osteonecrosis of the femoral head. However, we remain concerned about the long-term implications of the noise that was reported in these hips.

Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

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