TOTAL HIP-ARTHROPLASTY FOR AVASCULAR NECROSIS AND DEGENERATIVE OSTEOARTHRITIS OF THE HIP

Although several studies of various treatment modalities have been rep orted during the past decade, osteonecrosis of the femoral head remain s a difficult therapeutic problem, Total hip replacement which is rese rved for patients showing collapse of the femoral head, usually shows poorer results in patients with osteonecrosis compared with those with osteoarthritis, Uncemented total hip arthroplasty was performed on 29 patients with avascular necrosis of the femoral head and 29 patients with degenerative osteoarthritis, After a mean followup of 7.6 years a nd 7.1 years for the two groups of patients, only one failure was obse rved in one patient with osteonecrosis. Clinical evaluation after ceme ntless total hip arthroplasty in both groups of patients revealed impr ovement in all parameters. Postoperatively, pain improved from 1.4 to 5.1, walking ability from 3.4 to 5.3, and range of motion from 4.5 to 5.5 in patients with osteonecrosis, and pain improved from 1.2 to 5.3, walking ability from 3.2 to 5.4, and range of motion from 3.1 to 4.7 in patients with osteoarthritis. Thigh pain was observed postoperative ly in only two and three patients treated for osteonecrosis and osteoa rthritis, respectively. The present results using cementless arthropla sty seem to be somewhat better than those reported for cemented arthro plasty in patients suffering from osteonecrosis. The clinical and radi ographic findings after non-cemented arthroplasty in patients with ost eonecrosis of the femoral head and in patients with degenerative arthr itis of the hip were similar in the two groups.