{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:28:40Z","timestamp":1790231320904,"version":"4.1.0"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,4,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Subchondral insufficiency fracture of the femoral head (SIFFH) occurs in elderly patients and might be confused with osteonecrosis of the femoral head (ONFH). Subchondral insufficiency fracture of the femoral head is an insufficiency fracture at the dome of the femoral head and has been known to be associated with osteoporosis, hip dysplasia, and posterior pelvic tilt. This study\u2019s aims were to evaluate (1) surgical complications, (2) radiological changes, (3) clinical results, and (4) survivorship of THA in patients with SIFFH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>From November 2010 to June 2017, 21 patients (23 hips); 5 men (5 hips) and 16 women (18 hips) underwent cementless THA due to SIFFH at our institution. Their mean age was 71.9 years (range, 57 to 86) at the time of surgery, and mean T-score was \u22122.2 (range, \u22124.2 to 0.2). The mean lateral center-edge angle, abduction, and anteversion of the acetabulum were 29.9\u00b0 (range, 14.8\u00b0 to 47.5\u00b0), 38.5\u00b0 (range, 31\u00b0 to 45\u00b0), and 20.0\u00b0 (range, 12\u00b0 to 25\u00b0), respectively. The mean pelvic incidence, lumbar kyphotic angle and posterior pelvic tilt were 56.4\u00b0 (range, 39\u00b0 to 79\u00b0), 14.7\u00b0 (range, \u221234\u00b0 to 43\u00b0), and 13.0\u00b0 (range, 3\u00b0 to 34\u00b0), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>An intraoperative calcar crack occurred in 1 hip. The mean anteversion and abduction of cup were 29.0\u00b0 (range, 17\u00b0 to 43\u00b0) and 43.3\u00b0 (range, 37\u00b0 to 50\u00b0), respectively. One patient sustained a traumatic posterior hip dislocation 2 weeks after the procedure, and was treated with open reduction. At a mean follow-up of 35.4 months (range, 24 to 79 months), no hip had prosthetic loosening or focal osteolysis. At the latest follow-up, the mean modified Harris hip score was 79.1 (range, 60 to 100) points, and mean UCLA activity score was 4.2 (range, 2 to 7) points. The survivorship was 95.7% (95% CI, 94.9% to 100%) at 6 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Cementless THA is a favorable treatment option for SIFFH in elderly patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>3<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.20.00410","type":"journal-article","created":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T14:00:16Z","timestamp":1637157616000},"page":"84-89","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Cementless Hip Arthroplasty in Patients with Subchondral Insufficiency Fracture of the Femoral 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