TY - JOUR T1 - Midterm results of total hip replacement in osteonecrosis of the hip joint TT - Kalça osteonekrozunda total kalça artroplastisinin orta dönem sonuçları AU - Cebesoy, Oguz AU - Erdemli, Bulent AU - Kose, Kamil AU - Guzel, Bahaddin AU - Cetin, İlker PY - 2006 DA - November JF - Acta Orthopaedica et Traumatologica Turcica PB - Turkish Association of Orthopaedics and Traumatology WT - DergiPark SN - 1017-995X SP - 301 EP - 306 VL - 40 IS - 4 LA - en AB - Objectives: We evaluated the midterm results of total hip arthroplasty (THA) for femoral neck osteonecrosis.Methods : The study included 59 patients (23 females, 36 males; mean age 45.6 years; range 24 to 66 years) who underwent THA in 72 hips. Osteonecrosis was secondary to fracture in the femoral neck in 11 hips (15.3%), was associated with steroid use in 23 hips (31.9%), and was idiopathic in 38 hips (52.8%). Functional evaluations were made with the hip scoring system of D’Aubigne and Postel. Bone-implant relations were assessed radiographically using the Gruen’s seven zones in the femur and Charnley’s three zones in the acetabulum. The mean follow-up was 4.1 years (range 2 to 7 years).Results: The mean D’Aubigne-Postel hip score was 11 . 8 (range 7 to 16), with good or excellentresultsin all hips. While no significant difference was found between cementless and hybrid systems (p>0.05), the mean hip score was significantly higher with press-fit acetabular systems compared to expansion cups (p<0.001). The effects of the following were found insignificant on the clinical outcome (p>0.05): etiology, metalon-metal or metal-on-polyethylene surfaces, and development of stress shielding in the proximal femur or of varus-valgus angulation in the femoral stem. However, the results were significantly less favorable in cases in which complications arose (p<0.001). Intraoperative complications were fissure in five patients and isolated trochanteric fracture in five patients, all of which occurred in cementless THA. Heterotopic ossification was seen in six hips. At the end of 6.5 years, mild polyethylene wear was detected in eight hips, two of which also hadfocal osteolysis in Gruen zone 1.Conclusion: Thanks to improvements in implant technology and surgical techniques, the results of both cementless and hybrid systems are satisfactory in hip osteonecrosis, regardless of the etiology. KW - Arthroplasty KW - replacement KW - hip KW - femur head necrosis/ surgery KW - hip joint/radiography KW - hip prosthesis N2 - Amaç: Femur başı osteonekrozunda total kalça artroplastisinin (TKA) orta dönem sonuçları değerlendirildi.Çalışma planı: Osteonekroz tanısıyla TKA uygulanan 59 hastanın (23 kadın, 36 erkek; ort. yaş 45.6; dağılım 24-66) 72 kalçası incelendi. Osteonekroz 11 kalçada (%15.3) kollum femoriste kırığa bağlı gelişirken, 23 kalçada (%31.9) steroid nedenli idi. Otuz sekiz kalça (%52.8) ise idiyopatik olarak değerlendirildi. Klinik değerlendirmede D’Aubigne-Postel’in ameliyat sonrası fonksiyonel kalça skoru kullanıldı. Radyografik değerlendirmede, kemik-implant ilişkisi femur için Gruen’in yedi bölgesi, asetabulum için Charnley’in üç bölgesi kullanıldı. Ortalama takip süresi 4.1 yıl (dağılım 2-7 yıl) idi.Sonuçlar: Takip sonunda D’Aubigne-Postel kalça skoru ortalaması 11.8 (dağılım 7-16) bulundu. Tüm kalçalarda klinik sonuç iyi veya mükemmel idi. Çimentosuz ve hibrid sistemler arasında kalça skoru açısından anlamlı fark görülmezken (p>0.05), press-fit vidalı sistemin ekspansiyon kapa göre daha iyi olduğu görüldü (p0.05). Ancak, ameliyatta veya sonrasında komplikasyon gelişen kalçalarda klinik skor daha düşüktü (p UR - https://dergipark.org.tr/tr/pub/aott/article/190826 L1 - https://dergipark.org.tr/tr/download/article-file/168373 L1 - https://dergipark.org.tr/tr/download/article-file/168372 ER -