TOTAL HIP-ARTHROPLASTY IN PATIENTS WITH OSTEONECROSIS - THE EFFECT OFCEMENT TECHNIQUES

One hundred fifteen patients who underwent total hip replacement for o steonecrosis between June 1972 and April 1990 were divided into 3 grou ps according to the cause of the disorder: (1) osteonecrosis secondary to alcoholism (21 patients), (2) osteonecrosis secondary to hyperster oidism (29 patients), and (3) idiopathic osteonecrosis (65 patients), To determine the differences in short and long term arthroplasty failu re rates, these 3 patient groups were compared with a group of 202 pat ients who received total hip replacement for osteoarthritis. Statistic al analyses were carried out on the following definitions of failure: loosening of the acetabular component, loosening of the femoral compon ent, and revision arthroplasty, Radiolucency and postoperative pain sc ores also were evaluated, A significant difference in the rate of fail ure because of loosening of the femoral component was found among the 4 groups, Likewise, a significant difference was found among the 4 gro ups in all revisions or loosenings or both, However, only the comparis on between the idiopathic osteonecrosis and osteoarthritic groups show ed a significant difference with survival analysis, Second generation cement technique was as significant as any variable relating to failur e, The authors conclude that total hip arthroplasty is an equally viab le treatment for the 3 types of osteonecrosis examined in this study; however, failure might be more imminent in studies where larger number s are needed.