TO STUDY THE EFFECT OF COMBINED ANTEVERSION IN TOTAL HIP REPLACEMENT

Abstract

Introduction: In normal day-to-day life, the hip joint is the type of joint that undergoes a lot of stress during a persons normal daily activities. Since the hip joint is a vital joint that supports all joints in the body, normal and proper functioning of this joint is essential for maintaining a pain-free daily life.The overall success rate of total hip arthroplasty is largely determined by its ability to maintain hip stability and mobility while reducing pain in associated hip pathologies. The total joint replacement situation is in a state of constant development. Phillip Wiles was the first total hip replacement surgeon in London in 19381. Accurate positioning of the femoral and acetabular components is considered a prerequisite for successful total hip arthroplasty4-8. The optimal position of the stem and cup is an average anteversion angle of approximately 37 degrees (range: 25 to 50 ◦) 9-11 to avoid impingement and/or dislocation. Cup-to-stem or bone-to-bone impingement causes dislocation, accelerated wear, and pain in patients undergoing total hip replacement 12. McKibbin 13 first introduced the term in a study of infant cadavers and defined a total anteversion of 30 to 40 with his 15 anteversion of the femur as normal. Lewinnek8 defined his zone of safe cup alignment as his tilt of 40° ± 10° and his anteversion (AV) of 15° ± 10°.The Ranawat test is a visual assessment of compound anteversion when the femoral neck and head are flush with the acetabular opening. The angle of internal rotation to make the head and socket coplanar is combined anteversion.14 Therefore, dislocation is an important and critical complication which has to be avoided. In our study we are calculating combined version in total hip arthroplasty which will helpful in assessing the cup position post operatively with this we can assess the relation of stability of hip and functional outcome. Getting combined anteversion in safe zone of 40◦ ± 10◦ is important for surgeon to give patients a comfortable daily activities of living. Result: In our study, the mean total score was 90.10 ± 7.59in the postoperative 6 months period. Postoperative functional outcomes by Harris Hip Score at the end of the 6 months follow-up study were excellent in 17 patients (56.7%) and good in 11 patients(36.7%). Majority of the patients had good to excellent Harris Hip Score at final outcome with mean combined version 25-50%. Conculsion:The outcome of total hip arthroplasty performed depends on several factors, including component design, patient selection, mean bond angle, and surgical technique, determined by the outcome of the procedure should be evaluated in long-term studies. Our study suggests a favorable prognosis and outcome in the 20–60-year-old group with a mean age of 33.4. Of the 30 patients tested, 29 had a favorable postoperative outcome with normal range of combined version whose functional outcome is measured by the Harris Hip Score. The prosthesiss success and longevity depend on the restoration of the hip joints biomechanics .The goal was always to get the center of rotation back, limb length, medial and vertical offsets. Although this study was not without complications, the overall functional and clinical outcomes were excellent. Our study will require further follow-up and new patients as we were unable to obtain concrete results due to the small sample size.