• Liankui Yu, Chao Qi, Tengbo Yu, Qingyang Meng, Xia Zhao, Kai Liu, and Yan Cai.
• Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2013 Dec 1; 27 (12): 1409-13.

ObjectiveTo compare the short-term effectiveness between primary cemented and uncemented total hip arthroplasty (THA) for osteonecrosis of the femoral head (ONFH) after renal transplantation.MethodsThe clinical data were retrospectively analyzed from 18 patients (21 hips) with ONFH after renal transplantation undergoing cemented THA in 11 cases (13 hips) (cemented group) and uncemented THA in 7 cases (8 hips) (uncemented group) between February 2005 and February 2012. There was no significant difference in gender, age, disease duration, ONFH stage, preoperative Harris score, and bone density between 2 groups (P > 0.05). Postoperative complications were observed in 2 groups; the hip function was assessed based on Harris scores; X-ray film was used to observe the prosthetic situation.ResultsAll the wounds healed by first intention. The patients were followed up 6-77 months (mean, 46 months) in the cemented group, and 4-71 months (mean, 42 months) in the uncemented group. Femoral prosthesis infection occurred in 1 case (1 hip) respectively in each group; hip dislocation, femoral prosthesis loosening, and acetabular prosthesis loosening occurred in 1 case (1 hip) of the cemented group, respectively. At last follow-up, the incidences of postoperative complications and revision rate of the cemented group were 30.7% (4/13) and 23.1% (3/13) respectively, which were significantly higher than those of the uncemented group [12.5% (1/8) and 0 (0/8)] (P=0.047, P=0.040). Harris score was significantly increased to 94.1 +/- 3.7 in the uncemented group and 90.0 +/- 4.2 in the cemented group, showing significant differences compared with the preoperative scores in 2 groups (P < 0.05), but there was no significant difference between 2 groups (t = -1.815, P = 0.062). Postoperative X-ray films showed that the initial position of the prosthesis was satisfactory. At last follow-up, the bone fixation, fibrous stability, and loosening of the femoral prosthesis and loosening of acetabular prosthesis occurred in 9 hips, 3 hips, 1 hip, and 1 hip of the cemented group, respectively; bone fixation of the femoral prosthesis and stability of acetabular prosthesis were observed in all hips of the uncemented group. There was no heterotopic ossification in 2 groups.ConclusionUncemented THA after renal transplantation can obtain satisfactory shortterm effectiveness, and uncemented THA is better than the cemented THA; however, the middle- and long-term effectivenesses need further observation.

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