Uncemented total hip arthroplasty in chronic hemodialysis patients

Acta Orthop. 2010 Apr;81(2):178-82. doi: 10.3109/17453671003628749.

Abstract

Background and purpose: Whether or not uncemented total hip arthroplasty (THA) can achieve durable fixation of implants to bone in patients on chronic hemodialysis is unknown. We analyzed the 2-13-year clinical outcomes of cementless THA in patients with end-stage renal diseases who were maintained on long-term hemodialysis.

Patients and methods: We reviewed the outcome of 23 consecutive uncemented THAs undertaken between 1993 and 2004, in patients with chronic renal failure who had been on long-term hemodialysis (2-18 years). 1 patient died and 2 patients were lost to follow-up within 2 years, leaving 20 hips (20 patients, median age 66 (38-81) years at the time of THA, 11 females) that were reviewed at median 7 (2-13) years postoperatively.

Results: Radiographic bone-ingrowth fixation of the components was found in 19 patients. 1 patient had aseptic loosening requiring revision surgery. The median d'Aubigne and Postel score was 10 (8-14) preoperatively and 15 (12-18) at final review. No prosthetic infections were found in any of the patients.

Interpretation: Uncemented THA shows promising medium-term results in patients receiving long-term hemodialysis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip* / adverse effects
  • Arthroplasty, Replacement, Hip* / methods
  • Cementation
  • Female
  • Follow-Up Studies
  • Hip Joint / diagnostic imaging
  • Hip Prosthesis / adverse effects
  • Humans
  • Kidney Failure, Chronic / complications
  • Male
  • Middle Aged
  • Osteoarthritis, Hip / surgery
  • Prosthesis Failure
  • Radiography
  • Renal Dialysis* / adverse effects
  • Risk Factors
  • Time Factors
  • Treatment Outcome