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Partial hemiarthroplasty for the treatment of osteonecrosis of the femoral head

AN EXPERIMENTAL STUDY IN THE DOG

K. Ushio, MD, Orthopaedic Surgeon¹; M. Oka, MD, PhD, Professor Emeritus of Kyoto University (deceased)²; S.-H. Hyon, PhD, Associate Professor³; S. Yura, MD, Orthopaedic Surgeon¹; J. Toguchida, MD, PhD, Professor³; and T. Nakamura, MD, PhD, Professor and Chairman¹

¹ Department of Orthopaedic Surgery, Faculty of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606–8507 Japan.
² Kyoto City Rehabilitation Centre Hospital, Mibu, Nakagyou-ku, Kyoto 604–8854 Japan.
³ Institute for Frontier Medical Sciences, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606–8507 Japan.

Correspondence should be sent to Dr K. Ushio.

The use of a composite osteochondral device for simulating partial hemiarthroplasty was examined. The device was composed of a polyvinyl alcohol hydrogel and a titanium fibre mesh, acting as artificial cartilage and as porous artificial bone, respectively. The titanium fibre mesh was designed to act as an interface material, allowing firm attachment to both the polyvinyl alcohol gel (through injection moulding) and the femoral joint surface (through bony ingrowth). We implanted 22 of these devices into canine femoral heads. Histological findings from the acetabular cartilage and synovial membrane, as well as the attachment of the prosthesis to bone, were examined up until one year after operation.

No marked pathological changes were found and firm attachment of the device to the underlying bone was confirmed. The main potential application for this device is for partial surface replacement of the femoral head after osteonecrosis. Other applications could include articular resurfacing and the replacement of intervertebral discs.