Total hip replacement for management of severe osteoarthritis in a developing country: A 5-year assessment of functional outcome in 72 consecutive hip

Abstract

Background: Outcome assessment of joint replacement procedures allows providers and patients to evaluate the quality of services delivered, thereby adding value to the services provided. Objective: The study is to describe the pattern of presentations of our patients with hip osteoarthritis who had undergone cementless total hip replacement (THR), assess the outcome using the Harris Hip Score (HHS), and identify any variables that affect the outcome. Patients and Methods: The study was carried out at Davidson and Judith Consultants Clinics, Enugu, Nigeria. A total of 72 THRs, in 62 patients, carried out between 2008 and 2013 were reviewed. These patients were assessed using preoperative HHS (pre op HHS) and postoperative (post op HHS) administered at 1 year and 5 years. Results: There were 62 patients and 72 cementless THRs. Ten (16.13%) patients had bilateral conditions; 25 (40.32%) patients had right THR, while 27 (43.55%) patients had left THR. Twenty (32.26%) patients were males and 42 (67.74%) were females. Male:female is 1:2.1 patients. The most common cause from the study is still primary osteoarthritis which accounts for 51.6%, while the least is avascular necrosis (AVN) of the head of femur seen in hemoglobinopathy (22.58%). Those following idiopathic AVN are slightly higher (22.58%), while posttraumatic is 25.81%. The comparison of means of HHS shows pre op HHS and post Op HHS at 1 year has P = 000 (P 0.05). The comparison of HHS means for morbidity shows comorbidity post op HHS and no comorbidity post op HHS at 1 year had P =0.320 (P > 0.05). Conclusion: Our patients presented at a younger age with secondary osteoarthritis secondary to hip joint affectations such as trauma and AVN and they benefited from our intervention with very low complication rate.