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Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
Longevity of total hip arthroplasty implants in patients with Gaucher disease
Daniel Cohen1, Dina Kogan2, Amir Rubin1
1Department of Orthopaedic surgery, Shaare-Zedek Medical Centre, affiliated with the Hebrew University, Jerusalem, Israel.
Insights
Total hip replacement (THR) offers a safe option for Gaucher disease patients with hip arthritis. Ceramic-on-ceramic implants show better longevity, especially in older patients, improving quality of life.
Area of Science:
- Orthopedics
- Genetics
Background:
- Gaucher disease often leads to hip osteonecrosis and arthritic joint degeneration.
- Total hip replacement (THR) is a common treatment, but long-term outcomes in Gaucher patients require further evaluation.
Purpose of the Study:
- To evaluate the long-term outcomes of total hip replacement (THR) in patients with Gaucher disease.
- To identify factors influencing implant survival and patient quality of life.
Main Methods:
- Retrospective analysis of hip replacement data from a Gaucher disease clinic.
- Collection of patient demographics, implant details, radiographic loosening, and revision success rates.
Main Results:
- A cohort of 48 patients (54 hips) showed a 15-year implant survival of 60% (average 12.8 years).
- Cementless ceramic-on-ceramic implants demonstrated superior longevity with no revisions.
- Older age at surgery correlated with reduced revision risk; gender and genotype had no significant impact.
Conclusions:
- THR is a recommended treatment for symptomatic hip arthrosis in Gaucher disease patients, particularly those of older age.
- Ceramic-on-ceramic bearing surfaces show promising long-term results in this patient group.
Background:
Total hip replacement (THR) is performed for arthritic hip joints, which in Gaucher disease results from osteonecrosis of the femoral head. This procedure was recommended as valid and safe for this group of patients. Nevertheless, long term outcome has not been evaluated in a large cohort.
Methods:
Data regarding all patients having hip replacement in a relatively large Gaucher clinic was collected. Specifically, details such as patient background and quality of life, implant types, radiographic signs of implant-loosening, and success of implant revision were gathered.
Results:
The cohort included 48 patients (females 42%, mean age at operation 42 ± 14 years), having 54 hip implants. 15 years survival was 60% and an average implant life was 12.8 years. Longevity was related to implant type, with cementless implants using ceramic-on-ceramic bearing surfaces performing better than other types (no revisions so-far). Older age at surgery also involved a lower revision risk. Gender, disease genotype, and use of cement during the procedure did not have significant effect on longevity. As expected, quality of life and hip related function were better for patients who did not undergo revision. This implies the importance of long-term implant survival.
Conclusion:
Based on these results we recommend THR as a viable treatment for symptomatic hip arthrosis, especially at older age. Specifically, the utilisation of ceramic on ceramic bearing surfaced shows promising result in patients with Gauchers disease.
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