Monobloc Implants in Cementless Total Hip Arthroplasty in Patients with Legg-Calve-Perthes Disease: a Long-term Follow-up

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2017 Sep 6

PMID 28870190

Citations 7

Authors

Ze-Yu Luo

Hao-Yang Wang

Duan Wang

Hui Pan

Fu-Xing Pei

Zong-Ke Zhou

Affiliations

Soon will be listed here.

Abstract

Background: The purpose of this study was to evaluate 10-year outcomes in cementless monobloc total hip arthroplasty (THA) in a group of hips with Legg-Calve-Perthes disease (LCPD).

Methods: We reviewed 71 patients (88 hips) who underwent cementless THA with a diagnosis of LCPD from 2003 to 2009. From the total of 71 patients, 34 men and 37 women with an average age of 49.94 years were included. The mean follow-up period was 10 years.

Results: The mean Harris Hip Score improved significantly from 46.42 to 89.70. Similarly, the postoperative range of motion, hip dysfunction and osteoarthritis outcome score and SF-12 score also significantly improved. The mean leg lengthening was 22.1 mm. During the follow-up, eight complications were noted, including two cases of intraoperative femoral fractures, two cases of sciatic nerve paralysis, two cases of heterotrophic ossifications, one case of thigh pain and one case of dislocation. One revision was conducted for a periprosthetic fracture, and the survivorship at 10 years was 98.3%.

Conclusions: These data suggest that the monobloc stem can lead to satisfactory outcomes for clinical function, radiological evaluation, restoration of the normal limb lengths, complications, and survivorship among LCPD patients undergoing total hip arthroplasty.

Citing Articles

Approaching total hip arthroplasty after Legg-Calvé-Perthes disease: A case series and literature review.

Tong Y, Ihejirika-Lomedico R, Rathod P, Deshmukh A J Clin Orthop Trauma. 2024; 53:102478.

PMID: 39040624 PMC: 11260328. DOI: 10.1016/j.jcot.2024.102478.

Total hip arthroplasty in patients with common pediatric hip orthopedic pathology.

De Salvo S, Sacco R, Mainard N, Lucenti L, Sapienza M, Dimeglio A J Child Orthop. 2024; 18(2):134-152.

PMID: 38567046 PMC: 10984158. DOI: 10.1177/18632521241229608.

Total hip arthroplasty through the direct anterior approach for sequelae of Legg-Calvé-Perthes disease.

Hasler J, Flury A, Hoch A, Cornaz F, Zingg P, Rahm S Arch Orthop Trauma Surg. 2023; 143(9):5935-5944.

PMID: 36806985 PMC: 10449662. DOI: 10.1007/s00402-023-04791-4.

Cementless Total Hip Arthroplasty in Patients with Osteoarthrosis Secondary to Legg-Calvé-Perthes Disease Compared with Primary Osteoarthrosis: A Case-control Study.

Sansanovicz D, Croci A, Vicente J, Ejnisman L, Miyahara H, Gurgel H Rev Bras Ortop (Sao Paulo). 2022; 57(5):843-850.

PMID: 36226203 PMC: 9550378. DOI: 10.1055/s-0041-1732330.

Controlled fracture of the medial wall versus structural autograft with bulk femoral head to increase cup coverage by host bone for total hip arthroplasty in osteoarthritis secondary to developmental dysplasia of the hip: a retrospective cohort study.

Mou P, Liao K, Chen H, Yang J J Orthop Surg Res. 2020; 15(1):561.

PMID: 33243268 PMC: 7690034. DOI: 10.1186/s13018-020-02088-5.

References

Loudon J, CHARNLEY J . Subsidence of the femoral prosthesis in total hip replacement in relation to the design of the stem. J Bone Joint Surg Br. 1980; 62-B(4):450-3. DOI: 10.1302/0301-620X.62B4.7430222. View

Gruen T, McNeice G, Amstutz H . "Modes of failure" of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res. 1979; (141):17-27. View

Boyd H, Ulrich S, Seyler T, Marulanda G, Mont M . Resurfacing for Perthes disease: an alternative to standard hip arthroplasty. Clin Orthop Relat Res. 2007; 465:80-5. DOI: 10.1097/BLO.0b013e318156bf76. View

Engh Jr C, Culpepper 2nd W, Engh C . Long-term results of use of the anatomic medullary locking prosthesis in total hip arthroplasty. J Bone Joint Surg Am. 1997; 79(2):177-84. View

KELLY Jr F, Canale S, Jones R . Legg-Calvé-Perthes disease. Long-term evaluation of non-containment treatment. J Bone Joint Surg Am. 1980; 62(3):400-7. View

Wan Z, Malik A, Jaramaz B, Chao L, Dorr L . Imaging and navigation measurement of acetabular component position in THA. Clin Orthop Relat Res. 2008; 467(1):32-42. PMC: 2600979. DOI: 10.1007/s11999-008-0597-5. View

Upadhyay S, Burwell R, Moulton A . Femoral anteversion in Perthes' disease with observations on irritable hips. Application of a new method using ultrasound. Clin Orthop Relat Res. 1986; (209):70-6. View

Traina F, De Fine M, Sudanese A, Calderoni P, Tassinari E, Toni A . Long-term results of total hip replacement in patients with Legg-Calvé-Perthes disease. J Bone Joint Surg Am. 2011; 93(7):e25. DOI: 10.2106/JBJS.J.00648. View

Lim Y, Kim M, Suk Lee Y, Kim Y . Total Hip Arthroplasty in Patient with the Sequelae of Legg-Calvé-Perthes Disease. Hip Pelvis. 2016; 26(4):214-9. PMC: 4971396. DOI: 10.5371/hp.2014.26.4.214. View

10.

Greidanus N, Mitchell P, Masri B, Garbuz D, Duncan C . Principles of management and results of treating the fractured femur during and after total hip arthroplasty. Instr Course Lect. 2003; 52:309-22. View

11.

Brooker A, Bowerman J, Robinson R, RILEY Jr L . Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg Am. 1973; 55(8):1629-32. View

12.

Amstutz H, Su E, Le Duff M . Surface arthroplasty in young patients with hip arthritis secondary to childhood disorders. Orthop Clin North Am. 2005; 36(2):223-30, x. DOI: 10.1016/j.ocl.2005.01.005. View

13.

Engh C, Bobyn J, Glassman A . Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg Br. 1987; 69(1):45-55. DOI: 10.1302/0301-620X.69B1.3818732. View

14.

Lee S, Yoo J, Kim H . Alumina-alumina total hip arthroplasty for the sequelae of Legg-Calve-Perthes disease: A comparative study with adult-onset osteonecrosis. J Orthop Sci. 2016; 21(6):836-840. DOI: 10.1016/j.jos.2016.07.010. View

15.

Lee K, Jo W, Ha Y, Lee Y, Goodman S, Koo K . Total hip arthroplasty using a monobloc cementless femoral stem for patients with childhood Perthes' disease. Bone Joint J. 2017; 99-B(4):440-444. DOI: 10.1302/0301-620X.99B4.BJJ-2016-0259.R1. View

16.

Stulberg S, Cooperman D, Wallensten R . The natural history of Legg-Calvé-Perthes disease. J Bone Joint Surg Am. 1981; 63(7):1095-108. View

17.

Weber M, Lechler P, Von Kunow F, Vollner F, Keshmiri A, Hapfelmeier A . The validity of a novel radiological method for measuring femoral stem version on anteroposterior radiographs of the hip after total hip arthroplasty. Bone Joint J. 2015; 97-B(3):306-11. DOI: 10.1302/0301-620X.97B3.34618. View

18.

Gower W, Johnston R . Legg-Perthes disease. Long-term follow-up of thirty-six patients. J Bone Joint Surg Am. 1971; 53(4):759-68. View

19.

Al-Khateeb H, Kwok I, Hanna S, Sewell M, Hashemi-Nejad A . Custom cementless THA in patients with Legg-Calve-Perthes Disease. J Arthroplasty. 2013; 29(4):792-6. DOI: 10.1016/j.arth.2013.08.007. View

20.

Biant L, Bruce W, Assini J, Walker P, Walsh W . The anatomically difficult primary total hip replacement: medium- to long-term results using a cementless odular stem. J Bone Joint Surg Br. 2008; 90(4):430-5. DOI: 10.1302/0301-620X.90B4.19718. View