Total hip arthroplasty after avascular necrosis of the femoral head: does etiology affect the results?

Arch Orthop Trauma Surg. 2004 Mar;124(2):82-5. doi: 10.1007/s00402-003-0630-9. Epub 2004 Jan 23.


Introduction: The aim of the study was to evaluate the results of total hip arthroplasty (THA) due to avascular necrosis (AVN) of the femoral head and to establish whether the cause of AVN affects the results.

Material and methods: A group of 68 patients, 17-82 years of age (mean: 49.9 years) underwent 84 total hip arthroplasties due to AVN. The patients were divided into subgroups according to the etiology of AVN of the hip joint. The results of each group were evaluated by the Harris Hip score (HHS) at 3-18 years (mean: 6.2 years). The complication rate was also assessed.

Results: The mean preoperative HHS was 28.5+/-4.5 as opposed to a postoperative HHS of 86+/-10. The revision rate was 16.7%. Etiology does not affect the final outcome, but less favorable long-term results were found in the steroid-induced AVN patients.

Conclusions: Despite the previously reported, less favorable results, THA is a good option for the younger population, even with AVN, especially in bilateral disease. Etiology did not affect the final outcome. However, patients with steroid-induced AVN should be informed that although their final functional results will equal those of other groups, the longevity of the implants is limited.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip*
  • Bone Cements / therapeutic use
  • Female
  • Femur Head Necrosis / etiology*
  • Femur Head Necrosis / surgery*
  • Follow-Up Studies
  • Hip Fractures / complications
  • Humans
  • Male
  • Middle Aged
  • Reoperation / statistics & numerical data
  • Steroids / adverse effects
  • Treatment Outcome


  • Bone Cements
  • Steroids