TOTAL HIP-ARTHROPLASTY IN PATIENTS WITH A VASCULAR NECROSIS OF THE FEMORAL-HEAD - A 2 TO 10-YEAR FOLLOW-UP

One hundred twenty-three total hip arthroplasties were performed in 85 patients with osteonecrosis of the femoral head. There were 51 males and 34 females with an average age of 45 years. The average followup t ime was 4.6 years with a range of 2 to 10 years, API femoral stems and 71 sockets mere fixed with acrylic cement, Fifty-two of the sockets u sed were placed without cement, The average Harris hip score improved from 45 points preoperatively to 92 points at the time of last followu p. Of the 246 components used, 6 acetabular and 4 femoral prostheses i n 7 patients have been revised (4%), Two components (0.8%) were revise d for infection, 2 (0.8%) for repeated dislocation, and 6 (2.5%) for a septic loosening, There is current radiographic loosening in 3 acetabu lar and 2 femoral components (2%), None of the noncemented acetabular components was either radiographically loose or revised. Within the su bset of the 36 patients (52 hips) with a minimum 5-year followup (aver age, 6.6 years), 5 components (5%) were revised and 4 (4%) components are radiographically loose, The overall revision rate for cemented and hybrid hips at 2 to 10 years followup was 4%, The revision rate for h ybrid hips alone was 2.5% in the entire series and 2% for hips with a minimum followup of 5 years. These results seem significantly better t han previously reported, Using modern cement techniques and components , total hip arthroplasty can give excellent results in the young patie nt with avascular necrosis and may be the treatment of choice when rec onstructive surgery is required.