Arthroplasty in patients with extensive femoral head avascular necrosis

Purpose The purpose of this study was to investigate the outcomes of using cementless femoral stem for extensive osteonecrosis of the femoral head involving the proximal femur. Methods A total of 21 patients (27 hips) in the study group defined as extensive ONFH involving proximal femur and 42 patients (52 hips) with the diagnosis of regular osteonecrosis of the femoral head in the control group were enrolled in the study. Clinical and radiographic follow-ups were documented at three, six, 12 and 24 months postoperatively. Results Results improved for Harris hip score in both groups. In the study group undersized stem implantation and lateralized mal-position were identified. Subsequent subsidence was also found. Conclusions Pre-operative templating and intra-operative X-ray confirmation are necessary to avoid complications.