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Войти в исследования The Journal of arthroplasty · 2026
Total Hip Arthroplasty in Legg-Calve-Perthes Disease: Mean Nine-Year Outcomes of 201 Hips.
СтатьяНазвание и аннотация: Перевод в очереди
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Restrepo Diego J, Chen Aaron G, Guarin Perez Sergio F, Tai Ta-Wei, Trousdale Robert T, Mabry Tad M, Sierra Rafael J
Аннотация
BACKGROUND: Legg-Calvé-Perthes disease (LCPD) is an uncommon, but challenging indication for total hip arthroplasty (THA). We aimed to report one of the largest single-center contemporary series of THA associated with this condition.
METHODS: We reviewed 201 THAs for LCPD performed at a single institution between 2000 and 2020. The mean age at surgery was 47 years, the mean body mass index was 32 and 74% were men. Bearing surfaces included ceramic-on-highly cross-linked polyethylene in 95 hips (47%), metal-on-highly cross-linked polyethylene in 83 hips (41%), ceramic-on-ceramic in 17 hips (9%), and metal-on-metal in six hips (3%). All acetabular components were cementless. Cementless and cemented femoral stems were used in 188 (93%) and 14 hips (7%), respectively. The mean follow-up was nine years (range, two to 22).
RESULTS: At 15 years, survivorships free of aseptic revision, any revision, and any reoperation were 99, 98, and 95%, respectively. Indications for revision were infection (n = 2), postoperative fracture (n = 1), and metallosis (n = 1). There were no significant differences in survivorship between hips with prior surgical treatment of LCPD (n = 8) and those without (n = 153). Complications occurred in 30 hips, most commonly sciatic neuropraxia (n = 10) and intraoperative fracture (n = 9). Preoperatively, patients had a mean leg-length discrepancy of 18 mm shorter on the operative limb. Postoperatively, the operative limb was lengthened by a mean of 15 mm. There was no difference in mean lengthening between patients who had sciatic neuropraxia and those who did not (12 versus 15 mm; P = 0.365). There were seven neuropraxias resolved, while three patients had persistent deficits at the latest follow-up. The mean Harris Hip Score improved preoperatively from 55 to 92 at 10-year follow-up (P < 0.0001).
CONCLUSION: At 15 years, patients who had LCPD undergoing contemporary THA showed excellent survivorship free of revision and reoperation. Surgeons should be aware that complications were not uncommon, especially sciatic neuropraxia and intraoperative fractures.
LEVEL OF EVIDENCE: III.
METHODS: We reviewed 201 THAs for LCPD performed at a single institution between 2000 and 2020. The mean age at surgery was 47 years, the mean body mass index was 32 and 74% were men. Bearing surfaces included ceramic-on-highly cross-linked polyethylene in 95 hips (47%), metal-on-highly cross-linked polyethylene in 83 hips (41%), ceramic-on-ceramic in 17 hips (9%), and metal-on-metal in six hips (3%). All acetabular components were cementless. Cementless and cemented femoral stems were used in 188 (93%) and 14 hips (7%), respectively. The mean follow-up was nine years (range, two to 22).
RESULTS: At 15 years, survivorships free of aseptic revision, any revision, and any reoperation were 99, 98, and 95%, respectively. Indications for revision were infection (n = 2), postoperative fracture (n = 1), and metallosis (n = 1). There were no significant differences in survivorship between hips with prior surgical treatment of LCPD (n = 8) and those without (n = 153). Complications occurred in 30 hips, most commonly sciatic neuropraxia (n = 10) and intraoperative fracture (n = 9). Preoperatively, patients had a mean leg-length discrepancy of 18 mm shorter on the operative limb. Postoperatively, the operative limb was lengthened by a mean of 15 mm. There was no difference in mean lengthening between patients who had sciatic neuropraxia and those who did not (12 versus 15 mm; P = 0.365). There were seven neuropraxias resolved, while three patients had persistent deficits at the latest follow-up. The mean Harris Hip Score improved preoperatively from 55 to 92 at 10-year follow-up (P < 0.0001).
CONCLUSION: At 15 years, patients who had LCPD undergoing contemporary THA showed excellent survivorship free of revision and reoperation. Surgeons should be aware that complications were not uncommon, especially sciatic neuropraxia and intraoperative fractures.
LEVEL OF EVIDENCE: III.