PAST LETTERS FROM THE PRESIDENT
Phillip
S. Ragland, M.D.; Michael A. Mont, M.D.; German A. Marulanda, M.D.;
Ronald Delanois, M.D.; Neville B. Flowers, M.D.; and Thorsten Seyler,
M.D.
Introduction: The results of total hip arthroplasty in patients with avascular necrosis of the hip have been variable. This study analyzed the clinical and radiographic outcome of young patients (mean age of 39 years) treated with a proximally hydroxyapatite-coated tapered stem.
Methods: Sixty-seven patients (84 hips) treated with late-stage avascular necrosis of the hip with a proximally hydroxyapatite-coated tapered stem as part of their total hip arthroplasty were studied. There were 41 men and 26 women who had a mean age of 39 years (range, 18 to 80 years). Patient were followed both clinically and radiographically for a minimum of two years (mean of 3 years).
Results: Overall, there were good and excellent clinical outcomes in 78 hips (93%). Fair results were found in five patients with persistent pain. There was only one stem loosening (obese patient with SLE). Radiographic zonal analysis revealed no evidence of impending failure or progressive radiolucencies.
Discussion: Excellent short-term results were found with total hip arthroplasty in this difficult patient population. The proximally hydroxyapatite-coated tapered stem utilized in this study was useful in patients with avascular necrosis of the hip.