Cemented total hip arthroplasty in patients with osteonecrosis

Twenty patients with osteonecrosis of the femoral head underwent 28 total hip arthroplasties using cement from 1981 to 1985. Femoral reconstruction was by use of second-generation cement techniques. Twenty-four hips in 17 patients were available for review at a mean follow-up period of 7.7 years. The mean age at surgery was 55 years. Clinical evaluation demonstrated 79% excellent, 4% good, and 4% fair results. Three hips (12.5%) required revision for loosening. The cumulative probability of survival was estimated to be 85.7% at 10 years. Second-generation cement techniques and implant designs did improve the clinical results in this high-risk group; however, the overall mechanical failure rate remained high.