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, 2017, 8915104

A 10-Year Follow-Up of Two-Incision and Modified Watson-Jones Total Hip Arthroplasty in Patients With Osteonecrosis of the Femoral Head

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A 10-Year Follow-Up of Two-Incision and Modified Watson-Jones Total Hip Arthroplasty in Patients With Osteonecrosis of the Femoral Head

Shih-Jie Lin et al. Biomed Res Int.

Abstract

Long-term data and information indicating whether minimally invasive surgery (MIS) approaches are safe and effective with total hip arthroplasty (THA) are lacking. Between 2004 and 2006, 75 patients with alcohol-related osteonecrosis of the femoral head (ONFH) who underwent 75 THAs with the two-incision approach were studied. The medical records, radiographic parameters, and functional outcomes were collected prospectively. All data were compared with those for matched patients who underwent a modified Watson-Jones (WJ) approach. THA using the two-incision approach was associated with longer operation time, more blood loss, more lateral femoral cutaneous nerve injury, and more periprosthetic femoral fractures (p < 0.05 for all four) than the modified WJ approach. The Harris Hip Score (HHS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) increased significantly from the period preoperatively to 6 weeks postoperatively and thereafter up to the last follow-up in both groups. However, there were no significant differences in terms of radiographic parameters and functional outcomes between the two groups throughout the study period. Both the two-incision and the modified WJ approach provided satisfactory results and survival rates at a mean follow-up of 10.8 years. A prospective, randomized, large-scale cohort study is still warranted for evidence-based recommendations.

Figures

Figure 1
Figure 1
A 62-year-old male with alcohol-related ONFH underwent THA with a two-incision approach. (a) Immediate postoperative left hip anteroposterior view. (b) Loosening of femoral stem and hip dislocation occurred in the postoperative 6 months. (c) Revision of femoral component with long stem was performed. (d) Ten years later, the hip remains with good stability and adequate position.

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References

    1. Lee M. S., Hsieh P.-H., Shih C.-H., Wang C.-J. Non-traumatic osteonecrosis of the femoral head-from clinical to bench. Chang Gung Medical Journal. 2010;33(4):351–360. - PubMed
    1. Duwelius P. J. Two-incision minimally invasive total hip arthroplasty: techniques and results to date. Instructional Course Lectures. 2006;55:215–222. - PubMed
    1. Chen D., Berger R. A. Outpatient minimally invasive total hip arthroplasty via a modified Watson-Jones approach: technique and results. Instructional Course Lectures. 2013;62:229–236. - PubMed
    1. Foucher K. C., Wimmer M. A., Moisio K. C., et al. Time course and extent of functional recovery during the first postoperative year after minimally invasive total hip arthroplasty with two different surgical approaches—a randomized controlled trial. Journal of Biomechanics. 2011;44(3):372–378. doi: 10.1016/j.jbiomech.2010.10.026. - DOI - PubMed
    1. Wall S. J., Mears S. C. Analysis of published evidence on minimally invasive total hip arthroplasty. The Journal of Arthroplasty. 2008;23(7, article 55) doi: 10.1016/j.arth.2008.06.010. - DOI - PubMed
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