[Femoral head necrosis treated with total hip alloplasty]

One hundred and three patients with non-traumatic osteonecrosis of the femoral head had 144 primary total hip replacements performed. Average age was 47 (22-73) years. In 85 cases a cemented prosthesis, and in 45 cases an uncemented prosthesis was used, while 14 cases had a cemented femoral stem and an uncemented cup. At follow up, 25 patients had died, 13 patients had had a revision of the prosthesis, and two patients were lost to follow-up, leaving 63 patients (92 hips) for clinical and radiological evaluation. Kaplan-Meier plots for survival of the prosthesis were constructed, showing a total risk of failure of 8% at five years, increasing to 16% at seven years. In 89% of the patients without concomitant diseases, the clinical result was excellent or good. There was no difference in the clinical or radiological result in patients with cemented and uncemented prostheses. It is concluded, that the result after total hip replacement due to non-traumatic osteonecrosis of the femoral head is comparable to that of total hip replacement due to osteoarthrosis, and that an uncemented prosthesis can be expected to yield a result comparable to a cemented prosthesis.