الفهرس | Only 14 pages are availabe for public view |
Abstract Steroid dependant patients such as organ transplant patients under immunosupression and patients on steroid due to systemic diseases are high risk group to develop osteonecrosis of the femoral head. Progression of osteonecrosis leads to collapse with subsequent degenerative arthritis of the hip joint leading to marked disability in patients who are often systemically ill or who were recovering from organ or bone marrow transplantation, with all its devastating physical and psychological consequences. 70 total hip arthroplasty in 52 steroid dependant patients were performed in Mansoura university Hospital and Vancouver general hospital, British Columbia, Canada. There was 28 male and 24 female .The average age is 47.4 years, The average duration of follow-up was 16 months (range 12-55 months), 55 hips were managed by cementless THA, 7 Hybrid THA, and 8 cemented THA. ll patients were reviewed clinically and radiologically preoperatively then postoperatively at 6 weeks, 3 months, one year and then annually thereafter .The functional and the radiological results were analyzed. There was a significant improvement in the functional outcome scores (Harris hip score, WOMAC score), there was also improvement in the patient activity level (UCLA activity scale) but the improvement did not reach a statically significant value. The patients were satisfied from the result of the surgery. Radiological evaluation reveled all the acetabular component were soild fixed, non progressive radiolucent line was noted in 2 acetabular cups. All the cementless stems were bony ingrown except one stem was considered stable fibrous .all the cemented stem were solid fixed; only one stem shows non progressive radiolucent line. The surgical complication rate in our study was (7.1%), 3 peri-prosthetic fractures, one deep infection, one recurrent dislocation. |