The clinical and radiological outcome of uncemented primary total hip arthroplasty in case of AVN of femoral head in middle age group

Abstract

Background: The appropriate treatment of avascular necrosis (AVN) of the femoral head has become a serious problem around the world, particularly in adult instances. Objective was to evaluate the clinical and radiological outcome of uncemented primary total hip arthroplasty in case of AVN of femoral head in terms of pain relief, functional capacity, range of motion, absence of deformity, radiological assessment and comparing pre-operative and post-operative functional status.Methods: This was a prospective observational study of 44 hips of 37 patients at the National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh.Results: Here, majority (70%) belong to 30-35 years age group, and 75% were male. The affected site of arthroplasty among patients where highest (51.35%) patients had been affected on right side and right side number of hip was (40.42%). Among all, 30 patients underwent unilateral total hip replacement (THR), 7 patients who were affected bilaterally underwent staged bilateral THR at an interval of 6-12 weeks. According to the position of the acetabular component, anteverted in 70% patients, retroverted in 0% patients, neutral in 25% patient, <35º inclined in 0% patients, 35º-50º inclined in 65% patients, and >50º inclined in 20% patients at follow-up cases. Based on modified Harris hip score (HHS), 92% cases rated this treatment as excellent.Conclusions: Uncemented total hip arthroplasty in individuals, who have arthritis of the hip joint secondary to AVN, provides satisfactory clinical and radiographic outcome. Though the procedure is not free of complications, the overall functional and clinical outcome had shown excellent result.