Primary Total Hip Arthroplasty with Cementless VerSys Femoral Stem: a Minimum 5-years follow-up

PURPOSE: This study evaluated the clinical and radiographic results of primary total hip arthroplasty with a noncemented VerSys Fiber Metal Midcoat stem. MATERIALS AND METHODS: Thirty nine hips in thirty three patients were followed up for a minimum of five years. The clinical results were evaluated based on the Harris hip scores. Radiographic analysis of the femoral component was performed by evaluating the radiolucent lines, cortical hypertrophy, stress shielding, osteolysis and fixation stability. Radiographic analysis of the acetabular component was performed by evaluating the osteolysis and fixation stability. RESULTS: The average Harris hip score improved from 54.3 points preoperatively to 95.4 points at the last followup. In the results of radiographic analysis of the femoral component, stable bony ingrowth was noted in thirty-eight cases and stable fibrous ingrowth was observed in one. Non-progressive radiolucency<2 mm in width was observed in eight cases. There were three cases of osteolysis, thirty-six cases of stress shielding, and one case of cortical hypertrophy. Radiographic analysis of the acetabular component revealed stable bony ingrowth in thirty-eight cases and unstable fixation in one case. There were two cases of osteolysis. CONCLUSION: The results of primary total hip arthroplasty using cementless VerSys femoral stem after a minimum of five-year follow up revealed that the rate of femoral osteolysis had decreased and the rate of bone resorption by stress shielding was relatively high. However, a longer-term follow up will be needed.

Retrospective Study of Clinical Results of Anthovy's Technique with Scaphocapitate and Hamatocapitate Arthrodesis in Advanced Kienbock's Disease / 대한정형외과학회잡지

PURPOSE: A retrograde analysis of the clinical results of 11 cases of Kienbock's disease (Lichtman stage III), who underwent surgery for scaphocapitate or hamatocapitate arthrodesis followed by a rolled palmaris tendon replacement after a collapsed lunate excision. MATERIALS AND METHODS: This study followed-up 11 patients diagnosed with advanced Kienbock's disease for more than 5 years from January 1989 through May 2000. The patient's age ranged from 25 to 65 years old. Among the 11 patients, 7 patients received hamatocapitate arthrodesis, and the remainder received scaphocapitate arthrodesis. The Evans' scoring system was used for the clinical evaluation. RESULTS: After surgery, all patients showed complete radiologic fusion and an increase in grip strength, and most patients showed an increase in the ROM of a wrist joint, particularly in the group who received hamatocapitate arthrodesis. CONCLUSION: In advanced Kienbock's disease, a lunate excision followed by rolled tendon replacement with limited intercarpal arthrodesis showed relatively good results during the follow-up period, and had a particularly better ROM of the wrist joint in hamatocapitate arthrodesis, than the scaphocapitate arthrodesis because of the arthrodesis between the proximal and distal carpal row in the biomechanical aspect of the carpal bone.