Supportive Bone Cement Replacement for Osteonecrosis of the Femoral Head / 대한정형외과학회잡지

ABSTRACT

PURPOSE: To report early results of supportive bone cement replacement for medium to large size osteonecrotic femoral heads in young patients. MATERIALS AND METHODS: Forty-one osteonecrotic femoral heads in 38 patients, who received operation from Mar. 1998 to Feb. 2000, were reviewed. The mean age of the patients was 34.2 years (men; 33, women; 5). The preoperative mean Harris score was 48.6. Radiologic staging of Ficat showed I in 2 hips (5%), II-A in 7 hips (17%), II-B in 8 hips (20%) and III in 24 hips (59%). According to the index of necrotic extent (INE) by MRI, 8 hips (20%) were grade B and the remaining 33 hips (80%) were grade C. The operative method used was debridement of necrotic bone and bone cement replacement. Mean length of follow- up was 24.6 months. Three hips were lost to final follow-up. RESULTS: Postoperative immediate pain relief was observed in 38 hips (86%). Mean Harris score at the final follow-up was 77.3. Radiologic progression of stage was observed in 11 hips (27%), and no progression in the remaining 30 hips (73%). Arthoplasty was performed in 6 hips (15%), which were INE C in all cases. CONCLUSION: Supportive bone cement replacement is easier than other salvage techniques and produced a good result. INE was an important factor effecting postoperative results. Long term follow up is necessary.