Purpose: This study examined the association between the pre-operative body mass index (BMI) and the post total hip replacement arthroplasty result, as well as postoperative change in the life quality of patients diagnosed with femur head avascular necrosis (AVN).
Materials and Methods: Patients diagnosed with femur head AVN undergoing total hiparthroplasty (THA) with a ceramic-ceramic articular surface from March 2005 to May 2011 were analyzed retrospectively. The Harris hip score (HHS), 36-item short-form health survey (SF-36) score, radiological examination, and complications at two years or longer after THA in the 4 groups were analyzed in terms of the BMI (underweight group, normal weight group, overweight group, and obesity group).
Results: The normal body weight group showed the best result(94.36±7.51) in all scores but the difference was not significant. In the SF-36 physical scores, obese group showed the greatest improvement. Complications occurred frequently in the underweight(50%) and obese groups(19.5%). In particular, periprosthetic fractures (P=0.002) and pneumonia (P=0.005) occurred frequently in the underweight group.
Conclusion: The impacts of obesity and underweight on the clinical outcome after surgery are insignificant but patients with an abnormal BMI can expect a high quality of life after surgery.

The authors report a rare complication regarding the case of an 18-year-old female with bilateral osteonecrosis of the femoral head (ONFH) secondary to the treatment and hematopoietic stem cell transplant (HSCT) of an acute lymphoblastic leukemia (ALL). The patient underwent a bilateral necrotic bone debridement and core decompression (CD) surgery with injectable synthetic bone graft, which unfortunately caused a pulmonary injectable bone graft substitute embolism.

The increase in the number of primary total hip arthroplasties that will be performed over the next several decades will lead to an increase in the incidence of periprosthetic fractures around the femoral stem. A search of targeted articles was conducted using on-line databases of PubMed (National Library of Medicine) and articles were obtained from January 2008 to November 2021. Reliable prediction of treatment can be achieved using the Vancouver classification; internal fixation is indicated in fractures involving a stable implant and revision arthroplasty is indicated in those with unstable prostheses. To the best of our knowledge, relatively fewer studies regarding periprosthetic proximal femur fractures of cemented stems have been reported. The focus of this review is on the risk factors and strategies for treatment of these fractures for periprosthetic femoral fractures around a cemented hip arthroplasty.