RESUMEN
The linear penetration rates for ceramic femoral heads on conventional and highly cross-linked polyethylene were measured and compared with radiographs taken in the standing and supine position taken three weeks postoperatively and at final follow-up. Seventy-five patients (83 hips) with conventional polyethylene (group-1) and two hundred and seventy five patients (300 hips) with highly cross-linked polyethylene (group-2) were studied. Follow-up periods were 14.5years in group-1 and 8.6years in group-2. The average penetration rates in group-1 were 0.17mm/year in supine position and 0.18mm/year in standing position (P<0.05). On the other hand, the rates in group-2 were 0.03mm/year and 0.04mm/year respectively (P<0.05). Although there were statistical differences between groups, 0.01mm differences are probably not clinically relevant.
Asunto(s)
Artroplastia de Reemplazo de Cadera/instrumentación , Cabeza Femoral/diagnóstico por imagen , Prótesis de Cadera , Falla de Prótesis , Adulto , Anciano , Anciano de 80 o más Años , Materiales Biocompatibles , Cerámica , Femenino , Cabeza Femoral/cirugía , Humanos , Masculino , Persona de Mediana Edad , Polietileno , Postura , Radiografía , Adulto JovenRESUMEN
Patients who are treated with high-dose corticosteroids as an immunosuppressive therapy are at high risk of developing osteonecrosis, especially in the femoral head. We examined whether symptomatic osteonecrosis of the femoral head (ONFH) would be a clinical problem after liver transplantation. From June 1990 to December 2001, a total of 169 patients underwent liver transplantation at the Shinshu University Hospital. Within this group, 65 patients were more than 18 years old at the time of surgery, and all were enrolled in the present study. All patients were referred to the Orthopaedic Department of Shinshu University Hospital when they experienced musculoskeletal symptoms, including hip or groin pain. In addition, they were informed of the potential risk of osteonecrosis associated with immunosuppressive therapy after the liver transplant. As result, the patients were advised to have a magnetic resonance imaging (MRI) check for osteonecrosis after transplant surgery. In terms of outcomes, none of the patients presented with symptomatic hip difficulties due to osteonecrosis. Additional clinical investigation revealed that of the 18 patients who underwent MRI screening, only one was found to have asymptomatic unilateral ONFH. In conclusion, ONFH after liver transplantation has not been a clinical problem for our patients.