Cementless Total Hip Arthroplasty In Patients With Avascular Necrosis Of The Femoral Head

[Objective]To evaluate the cilinical and radiographic results of cementless total hip arthroplasty(THA) in patients with avascular necrosis of the femoral head(AVNFH).[Methods]A series of 76 patients (91 hips) with AVNFH who had undergone Cementless THA from 2000 were involved in this study. 52 hips in 42 patients (55.3%) were available for this review .The mean follow-up was 26.8 months (range,6～96 months).23 procedures were done in 18 men ,and 29 procedures were done in 24 women. The underlying diagnosis was steroid-induced in 10 patients (15 hips), post-traumatic in 8 patients (8 hips), idiopathic in 24 patients(29 hips). Of the 52 hips,27 were FicatⅢand the other 25 were FicatⅣ. Clinical and radiographic results were evaluated. Clinical outcomes were evaluated according to Harris score,function and contentment rate. Components migration,bone remodelling around the implant and polyethylene wear were assessed in the anteriorposterior and lateral X-ray of the hips.[Results]The average Harris score improved from 42 to 93 and the contentment rate was 98.1%. One patient suffered from thigh pain at the final follow-up. Stress shielding and ectopic ossification were observed in 14 hips and 5 hips, respectively. No radiographic loosening and revision arised.[Conclusion]Cementless THA in patients with AVNFH had a satisfactory clinical and radiographic outcomes. Complications,such as stress shielding,ectopic ossification, polyethylene wear and loosening of the components cannot be avoided. With the developing of the surgical technique and improvement of the material and design of the implant,these complications will reduce ,but a further follow-up is still necessary.