Functional outcomes of bilateral hip necrosis: total hip arthroplasty versus extracorporeal shockwave

This study compared the functional outcomes of total hip (THA) in one and shockwave (ESWT) in the other in 17 patients with bilateral hip necrosis. In THA side, only one type of prosthesis was used and all components were press fixed. In ESWT side, each hip received 6,000 impulses of shockwave at 28 kv. The evaluations included pain score and Harris hip score, radiographs and MR images. The magnitudes of improvement in pain and function favored the ESWT side. Thirteen patients rated ESWT better than THA; four patients reported comparable results between THA and ESWT, and none graded THA better than ESWT. Better functional outcomes were observed after ESWT for early hip necrosis than THA for late cases in patients with bilateral hip disease.