TREATMENTS FOR AVASCULAR NECROSIS OF THE FEMORAL HEAD USING SHORT-STEM HIP ARTHROPLASTY

Abstract

Osteonecrosis of the femoral head (ONFH) develops when the bone in the head of the femur dies and gradually collapses due to the disruption of its blood supply. Total hip arthroplasty (THA) is the standard treatment for patients with late-stage ONFH. However, there is uncertainty about the type of prosthesis design that provides the best outcome. During the last decade, despite the increasing number of researches on short-stem prostheses, it is still questionable whether they represents a risk factor for failure after implantation. The aim of this study was to review researches comparing the outcome of short-stem and conventional-stem arthroplasty in ONFH and to present the pros and cons of short-stem hip arthroplasty in osteonecrosis of the femoral head. The short- to medium-term results showed predominantly good outcomes. However, due to differences in the design of short stems and their fixation, it is hard to draw a general conclusion. Short stems with primary diaphyseal fixation do not reveal a high increased risk of failed integration or loosening. For designs with a primary metaphyseal anchorage, an MRI should be conducted to exclude that the necrosis exceeds the femoral neck.