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Hemiarthroplasties in young patients with osteonecrosis or a tumour of the proximal femur; an observational cohort study.
- Source :
-
BMC musculoskeletal disorders [BMC Musculoskelet Disord] 2013 Jan 17; Vol. 14, pp. 31. Date of Electronic Publication: 2013 Jan 17. - Publication Year :
- 2013
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Abstract
- Background: The failure scenario in total hip arthroplasty (THA), in younger patients, is dependent on the fixation and wear of the acetabular component. In selected cases, where endoprosthetic replacement of the femoral head is unavoidable for limb salvage or functional recovery, hemiarthroplasty can be chosen as an alternative. The purpose of this study is to evaluate hemiarthroplasty as treatment strategy for young patients with osteonecrosis or a tumour of the proximal femur.<br />Methods: Between 1985 and 2008, 42 hemiarthroplasties (unipolar and bipolar) were performed in patients younger than 65 years with osteonecrosis (n=13) or a tumour of the proximal femur (n=29). All patients were seen at yearly follow-up examination and evaluated. Revision or conversion to a THA was regarded as a failure of the implant. A Kaplan Meier analysis was performed. To determine significant differences between categorical groups, the Pearson chi-square test was used. In numerical groups the independent T-test and One-way ANOVA were used.<br />Results: After a mean follow-up of 7.1 years, failure of the hemiarthroplasty occurred 6 times. The Kaplan Meier survival analysis with conversion to THA or revision as endpoint of the bipolar hemiarthroplasties (n=38) shows a 96% survival at 15, and 60% at 20 years. In the unipolar type (n=4) we found a conversion rate of 50% within 3 years.<br />Conclusions: Bipolar hemiarthroplasty is a reasonable alternative in a young patient with osteonecrosis or a tumour of the proximal femur as indication. Because of the high conversion rate after unipolar hemiarthroplasties, we would not recommend this type of prosthesis in the young patient.
- Subjects :
- Adolescent
Adult
Aged
Breast Neoplasms secondary
Chondroblastoma pathology
Chondroblastoma surgery
Cohort Studies
Female
Femoral Neoplasms pathology
Femoral Neoplasms secondary
Femur pathology
Giant Cell Tumor of Bone pathology
Giant Cell Tumor of Bone surgery
Hemiarthroplasty adverse effects
Hip Prosthesis
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Osteonecrosis pathology
Prosthesis Failure etiology
Sarcoma pathology
Sarcoma secondary
Sarcoma surgery
Survival Rate
Young Adult
Femoral Neoplasms surgery
Femur surgery
Hemiarthroplasty methods
Osteonecrosis surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2474
- Volume :
- 14
- Database :
- MEDLINE
- Journal :
- BMC musculoskeletal disorders
- Publication Type :
- Academic Journal
- Accession number :
- 23327536
- Full Text :
- https://doi.org/10.1186/1471-2474-14-31