2023, Vol. 27 ›› Issue (13): 2028-2032

Acetabular wear after femoral head replacement: cause and management

Wang Shangzeng1, Wang Zhen2, You Mingcan3, Ma Shang2, Shen Jintao4   

Abstract: BACKGROUND: The incidence of different types of acetabular wear after femoral head replacement varies between different studies. With the increase of clinical artificial femoral head replacement cases, its complications also appear gradually.  
OBJECTIVE: To investigate the causes and management strategies of acetabular wear after femoral head replacement.
METHODS: From June 2012 to October 2019, 56 failed cases of acetabular wear after femoral head replacement (56 hips) were admitted to the Department of Joint Medicine of Henan Province Hospital of TCM and received the total hip joint revision surgery. All patients were suffered hip pain with limited movement. Harris score was 33.71±1.85 and VAS score was 6.91±0.67 preoperatively. All cases were followed up regularly 3, 12, and 24 months postoperatively, once every year thereafter. The results of preoperative and postoperative follow-up were analyzed.  
RESULTS AND CONCLUSION: (1) 56 patients were followed up for 24-72 months, mean (47.52±15.80) months. X-ray films showed that all prostheses were no loosening and had good position as well as normal alignment. There was no infection or other complications. (2) The Harris score at each time point of postoperative follow-up was significantly higher than that before surgery (P < 0.05), and the visual analogy scale score was significantly lower than that before surgery (P < 0.05). There was no significant difference in Harris score or visual analogy scale score at 24 and 12 months after operation. (3) It is concluded that the non-infective complication after femoral head replacement is mainly acetabular cartilage wear; pain is a major symptom. In the clinic, if the cartilage damage or degeneration is obvious or the life expectancy is long, artificial femoral head replacement should be used with caution. If the acetabular cartilage is worn and painful after surgery, the solution is to give the patient a first-stage total hip revision. It would rebuild the hip joint and restore the normal function of the hip joint.
Key words: artificial femoral head replacement, acetabulum, wear, hip revision, complication