Treatment of Osteonecrosis: Treatment by Femoral Osteotomy

1998 ◽  
Vol 8 (3) ◽  
pp. 154-158 ◽  
Author(s):  
F. Menschik ◽  
K.D. Schatz ◽  
R. Kotz
Keyword(s):  
Femoral Head ◽  
Survival Curve ◽  
Weight Bearing ◽  
Harris Hip Score ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Total Hip ◽  
Special Cases ◽  
Hip Arthroplasties

The purpose of the use of an osteotomy for the treatment of osteonecrosis (ON) of the femoral head is to move the necrotic segment away from the major load-transmitting area of the acetabulum and to redistribute the weight-bearing forces to articular cartilage that is supported by healthy bone. The most common osteotomies are the varus, valgus, flexion, rotational (Sugioka), and combined osteotomies. Their long term outcome, reported in the literature, is quite controversial. We found a decreasing frequency of flexion osteotomies between 1986 and 1996 performed at our department. In 1977 we started with the Sugioka osteotomy in special cases of femoral head ON (necrotic angle in the AP-view about 90 degree) resulting in a total of 51 cases. Forty-one of them have been analyzed regarding complications, reoperations and Harris Hip Scores. Seventeen of 41 patients developed complications and underwent reoperation. Nevertheless the results according to the Harris Hip Score were satisfactoy (excellent and good in 24 patients fair in 10 and poor only in 7 cases). Independently from the size of the necrosis total hip arthroplasties have been performed in 8 cases. The survival curve of 41 Sugioka osteotomies shows a 50% decrease at 6 years. Due to this fact and the regression in the number of osteotomies of the femur in cases of ON of the hip joint we find in our material that the importance of osteotomies has dramatically decreased in contrast to the excellent results of total hip arthroplasty.

scholarly journals Long-Term Outcome after Rehabilitation of Bilateral Total Hip Arthroplasty in Renal Transplant Recipient – A Case Report

2016 ◽  
Vol 4 (1) ◽  
pp. 146-151
Author(s):  
Erieta Nikolikj Dimitrova ◽  
Aleksandar Adamov ◽  
Valentina Koevska ◽  
Biljana Mitrevska ◽  
Ivan Gacevikj ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Clinical Findings ◽  
Harris Hip Score ◽  
Avascular Osteonecrosis ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Total Hip

INTRODUCTION: Total hip replacement is generally proposed for renal transplant patients with avascular osteonecrosis of the femoral head.PURPOSE: The purpose of the study is to report the long-term outcome after rehabilitation of bilateral total hip arthroplasty in a patient with renal transplantation suffering from avascular osteonecrosis of the both femoral heads.MATERIAL AND METHOD: The patient S.D, 49 years old at follow-up. Few months after renal transplantation, the patient had got avascular osteonecrosis of both femoral head. One year after transplantation the total hip arthroplasty for both hip joints were performed. Three years later repeat total hip arthroplasty surgery for left hip was performed. After any surgery intervention the patient was referred for inpatient rehabilitation. For clinical assessment the clinical findings and Harris Hip Score have been used. The rehabilitation program consisted of exercises, occupational therapy, and patient education. RESULTS: After any rehabilitation treatment the patient had improvement of clinical findings. At follow-up assessment outcome for both hip function was good - Harris Hip Score was 81 points.CONCLUSION: Rehabilitation is integral part of multidisciplinary treatment of renal transplant recipient after total hip arthroplasty. Regular exercise training of these patients is very important for improving of their long-term outcome.

scholarly journals Long-Term Outcome of Total Hip Replacement in Patients with or without Femoral Head Contamination

2011 ◽  
Vol 19 (2) ◽  
pp. 174-176 ◽  
Author(s):  
Talal Ibrahim ◽  
Mayyar Ghazal Aswad ◽  
Joseph J Dias ◽  
Andrew R Brown ◽  
Colin N Esler
Keyword(s):  
Femoral Head ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Total Hip

Long-Term Outcome of Zürich Cementless Total Hip Arthroplasty in 439 Cases

2015 ◽  
Vol 44 (8) ◽  
pp. 921-929 ◽  
Author(s):  
Luca Vezzoni ◽  
Aldo Vezzoni ◽  
Randy J. Boudrieau
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty

Displacement of an Ununited Medial Humeral Condylar Ossification Centre in the Cat

2018 ◽  
Vol 31 (02) ◽  
pp. 153-157
Author(s):  
Kerstin Erles ◽  
Thomas Maddox ◽  
Andy Morris
Keyword(s):  
Weight Bearing ◽  
Distal Humerus ◽  
Acute Onset ◽  
Outcome Evaluation ◽  
Ossification Centre ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Similar Appearance ◽  
The Right

AbstractA 2-year-old cat was presented with the complaint of acute-onset non–weight-bearing lameness of the right forelimb. When examined, the cat was of short stature and had multiple joint and cartilaginous abnormalities suggestive of chondrodysplasia. The cause of the acute lameness was radiographically identified as a displaced osseous fragment from the medial portion of the right humeral condyle. The features of the osseous fragment were consistent with an ununited medial condylar ossification centre of the distal humerus. Furthermore, a nondisplaced ununited ossified fragment of similar appearance and size was present in the contralateral elbow. Surgical treatment by excision of the displaced fragment resulted in a preinjury level of limb function in the long-term outcome evaluation.

Treatment of coxofemoral luxation in a mature Welsh pony by femoral head ostectomy: Long-term outcome

2016 ◽  
Vol 29 (10) ◽  
pp. 528-533 ◽  
Author(s):  
I. B. François ◽  
A. L. Thomas ◽  
O. M. Lepage
Keyword(s):  
Femoral Head ◽  
Term Outcome ◽  
Long Term Outcome

Complications and Long-Term Outcome in 16 Canine Cementless Hybrid Hip Arthroplasties

2019 ◽  
Vol 32 (01) ◽  
pp. 073-078 ◽  
Author(s):  
Matej Matiasovic ◽  
Helmut Steger ◽  
Peter Böttcher ◽  
Karol Bayer
Keyword(s):  
Term Outcome ◽  
Long Term Outcome ◽  
Stem Subsidence ◽  
Screw Breakage ◽  
Clinical Benefits ◽  
Implant System ◽  
Hip Arthroplasties ◽  
Single Implant

Objective The purpose of this study was to retrospectively evaluate the complications and long-term outcomes of total hip arthroplasty (THA) using a hybrid cementless system. Materials and Methods Medical records of dogs that underwent THA using a combined implant system consisting of Innoplant Screw Cup, Kyon taper head and Zurich cementless (Z-THA) stem between March 2010 and March 2015 were reviewed. Dogs with a minimum follow-up of 2 years were included. Signalment, complications and outcome at the latest follow-up examination were recorded. Results Sixteen hybrid THA were performed in 12 dogs. Mean follow-up was 42.5 months. Overall complications occurred in three arthroplasties (19%) including luxation (n = 1), aseptic cup loosening (n = 1) and implant failure with screw breakage followed by stem subsidence (n = 1). Two arthroplasties including prosthesis luxation and aseptic cup loosening were successfully revised using the here described hybrid system and achieved full functional outcome at the last follow-up examination. One arthroplasty with screw breakage and secondary stem subsidence was treated conservatively and achieved an acceptable outcome. Conclusion Hybridization of the Innoplant Screw Cup, Kyon taper head and Zurich cementless for initial THA surgery is feasible. In comparison with the reported complications and outcomes for single implant THA systems, the hybrid THA did not prove to have greater clinical benefits for use in primary THA surgery.

Overestimation of the risk of revision with Kaplan-Meier presenting the long-term outcome of total hip replacement in older patients

2017 ◽  
Vol 28 (3) ◽  
pp. 246-253 ◽  
Author(s):  
Kalliopi Lampropoulou-Adamidou ◽  
Theofilos S Karachalios ◽  
George Hartofilakidis
Keyword(s):  
Cumulative Incidence ◽  
Older Patients ◽  
Relative Difference ◽  
Long Term Results ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Total Hip ◽  
Kaplan Meier

Introduction: The purpose of the present study was (i) to review the long-term outcome of cemented Charnley total hip replacements (THRs) performed by 1 surgeon (GH), 20 to 42 years ago, in patients ≥60 years, using both the Kaplan-Meier (KM) and the cumulative incidence (CI) methods, and (ii) to compare the estimations of the 2 statistical methods. Methods: We evaluated the outcome of 306 consecutive primary cemented THRs that were performed in 265 patients. The final clinical, radiographic assessment and satisfaction of living patients were also included. The survivorship was estimated with the use of KM and CI methods and the relative difference between their estimations was calculated. Results: Living patients’ final clinical results were significantly improved in comparison with respective preoperative ones, and all the acetabular and 91% of femoral components considered as well fixed. 95% of these patients reported satisfaction. The risk of revision at 25 years, with revision for aseptic loosening for 1 or both components as the endpoint, with 21 hips at risk, assessed with KM analysis was 6.9% and with CI approach was 3.9%. The relative difference between KM and CI estimations was increasing during follow-up, reaching up to 76.8% at 25 years. Conclusions: We concluded that fixation of implants with cement in older patients had satisfactory long-term results and can serve as a benchmark with which to compare newer fixation methods (hybrid and uncemented) and materials. However, KM method, in studies that include older population with long-term follow-up, may significantly overestimate the risk of revision and clinicians could consider using besides the cumulative incidence of competing risk method.

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