EVALUATION OF CLINICAL RESULTS AND FUNCTIONAL OUTCOME OF PRIMARY UNCEMENTED TOTAL HIP ARTHROPLASTY IN OSTEONECROSIS HEAD OF FEMUR

Abstract

Background: ONFH is a recalcitrant disease caused by inadequate blood flow to femoral head. Also known as the CORONARY DISEASE OF THE HIP, the end stages result in restricted hip joint ROM and limitation of activities of daily living. Head preservation techniques are contraindicated in advanced stages making the replacement arthroplasty the only option to restore mobility and relieve pain.

Objectives: To study the clinical results and functional outcome of uncemented THA in Osteonecrosis of femoral head.

Study design: The study was a prospective observational study. The modified Harris hip score was used to measure the outcome.

Participants: 25 patients satisfying the following criterias ; age > 20 yrs, all sexes, stage 3 and 4 Ficat & Arlet, Dorr A & B femori, unilateral ONFH.

Methods: After seeking approval from the IEC the study was conducted on 25 patients in SKIMS MCH Bemina from Feb 2018 to June 2019. All the patients were operated by a single surgeon and the implant used was same in all the patients.

Results: Average Harris Hip score improved from 65.875 pre-operatively to 96.52 in th post-op period with maximum improvements in pain scores.

Conclusion: THA is the only procedure providing pain relief and restoring joint mobility in advanced ONFH. Favourable short-term results were observed with uncemented hydroxyapatite coated stem and porous coated acetabular shell.

Implications: The study implied uncemented THA in advanced stages of osteonecrosis resulted in pain relief and restored hip joint ROM in short-term follow-up with minimal complications.

In addition the study also provided insight of epidemiology of ONFH in this part of world although the sample size was smaller.