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Hip arthroplasty for treatment of advanced osteonecrosis: comprehensive review of implant options, outcomes and complications

Authors Waewsawangwong W, Ruchiwit P, Huddleston J, Goodman S

Received 2 July 2012

Accepted for publication 12 January 2013

Published 28 June 2016 Volume 2016:8 Pages 13—29

DOI https://doi.org/10.2147/ORR.S35547

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Professor Clark Hung


Warit Waewsawangwong, Pirapat Ruchiwit, James I Huddleston, Stuart B Goodman

Department of Orthopedic Surgery, Stanford University, Stanford, CA, USA

Abstract: Surgical treatment for late stage (post-collapse) osteonecrosis of the femoral head is controversial. In these situations, the outcome of joint preservation procedures is poor. There are several arthroplasty options for late-stage disease. The clinical outcomes of hemiarthroplasty and hemiresurfacing are unpredictable because of progressive acetabular cartilage degeneration. Total hip resurfacing may be associated with further vascular insult to the femoral head and early failure of the implant. Total hip replacement with metal-on-conventional polyethylene bearing surfaces has been the gold standard, but implant survivorship is limited in young active patients due to wear and osteolysis. Newer alternative bearing surfaces may have improved wear characteristics, but their durability must be confirmed in longer-term studies.

Keywords: hip arthroplasty, advanced osteonecrosis, implant options, outcomes, complications

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