Document Detail


Cementoplasty in the treatment of avascular necrosis of the hip.
MedLine Citation:
PMID:  19132783     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: This retrospective study evaluated the role of percutaneous cementoplasty in the treatment of avascular necrosis (AVN) of the hip in order to postpone or avoid total hip replacement. METHODS: The study population comprised 40 patients (47 hips) with mean age of 46 +/- 4.7 years and mean body mass index of 26.7 +/- 4.6 kg/m(2). AVN was classified according to the Ficat-Arlet classification as one stage I, 30 stage II, and 16 stage III. The minimum followup was 9 months. RESULTS: It was found that 74.5% of hips were secondarily operated for total hip replacement a mean of 19.9 +/- 15 months (median 14 mo) after cementoplasty. As well, 94% of patients with stage 3AVN and 68% with stage 2AVN underwent surgery. Twelve hips were not operated, with a mean followup of 39 +/- 19.2 months. Pain decreased by more than 80% after cementoplasty in two-thirds of patients, but the mean pain-free interval was only 8.1 +/- 6.6 months (median 5 mo). Nineteen of the 29 working patients were able to transiently return to work. The outcome was more unfavorable with radiological stage III AVN, joint effusion, and/or a double-line sign around the lesions on magnetic resonance images. CONCLUSION: Despite early relief of pain, the results of the cementoplasty technique were disappointing, with need for arthroplasty surgery in most cases within 2 years. Alternative percutaneous techniques using different filler materials with osteoinductive properties should be evaluated in further studies.
Authors:
Nicolas Reuter; Alban Romier; Zephir Hambourg; Frédéric Palmieri; Dominique Fayet; Béatrice Pallot-Prades; Philippe Collet; Michel-Henry Fessy; Frédéric Farizon; Fabrice G Barral; Thierry Thomas
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of rheumatology     Volume:  36     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-11     Completed Date:  2009-04-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  385-9     Citation Subset:  IM    
Affiliation:
Service de Rhumatologie, INSERM U890, CHU de Saint-Etienne, 25 Boulevard Pasteur, 42055 Saint-Etienne Cedex 2, France.
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living
Adult
Arthralgia / etiology,  surgery
Bone Cements / therapeutic use*
Causality
Disability Evaluation
Disease Progression
Female
Femur Head / pathology,  radiation effects,  surgery
Femur Head Necrosis / pathology,  radiography,  surgery*
Hip Joint / pathology,  radiography,  surgery*
Humans
Male
Middle Aged
Orthopedic Procedures / methods*
Outcome Assessment (Health Care)
Postoperative Complications / etiology,  pathology,  physiopathology
Reconstructive Surgical Procedures / methods*
Retrospective Studies
Risk Factors
Surgical Procedures, Minimally Invasive / methods*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Bone Cements

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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