A three year prospective study of functional and clinical outcomes of total hip replacement at a tertiary care hospital

Background: Hip joint is a crucial joint in the body whose function is essential for normal daily activities. Osteoarthritis of the hip cripples the daily functional capacity and total hip arthroplasty is considered to relieve the pain and increase the quality of life among these patients. The objective of present study was to assess the clinical and functional outcome in total hip replacement patients in terms of early joint function and stability of the hip joint and also to assess complications of procedures.Methods: A three-year prospective study was conducted on 58 cases that fulfilled the inclusion criteria. Ethical approval and consent were obtained for the study. Standard clinical and laboratory evaluation was performed on all the cases and the data was noted in Microsoft excel sheet and analyzed. Modified Harris hip scoring was done pre operatively and postoperatively and follow-up was done at discharge, 4th week, 6 months and one year.Results: Surgery was performed on 58 cases with age range 34-73 years and a mean of 43.58 years. Avascular necrosis was the main indication (55.2%). Maximum patient follow-up was 38 weeks. The mean preoperative score was 41.04 with minimum score being 10 and maximum being 76, postoperative score was 99.63 with minimum 64 and maximum was 109. Statistical significance was observed between preoperative and postoperative scores with regard to the parameters of pain, gait, functional activity and range of motion. Anterior thigh pain was the common postoperative complaint (15.5%).Conclusions: In conclusion, total hip replacement gives good clinical and functional outcomes. However, the outcomes are influenced by multiple factors which include indication for surgery, age of the cases, and type of prosthesis, operative technique and post-operative follow up.

Download Full-text

Revision Total Hip Replacement: A Case Report

Delta Medical College Journal ◽

10.3329/dmcj.v1i2.15920 ◽

2013 ◽

Vol 1 (2) ◽

pp. 58-61

Author(s):

Md Hafizur Rahman ◽

Md Mohoshin Sarker ◽

Md Abdul Matin

Keyword(s):

Total Hip Replacement ◽

Hip Joint ◽

Hip Replacement ◽

Tertiary Care ◽

Bipolar Hemiarthroplasty ◽

Care Hospital ◽

Left Femur ◽

Total Hip ◽

History Of ◽

Revision Total Hip Replacement

Total hip replacement is a reconstructive procedure that has improved the management of those diseases of the hip joint that have responded poorly to conventional medical therapy. Conventional, primary total hip replacement is a durable operation in the majority of patients. A hip replacement is a mechanical device with parts that are assembled before and during the operation. But the possible complications of total hip arthroplasty, and its clinical performance over time, is a challenging occasion to the surgeons, and such a challenge we faced with our presenting patient. A 68 year old lady with history of cemented bipolar hemiarthroplasty done in a tertiary care hospital, due to fracture neck of the left femur having the history of diabetes, chronic kidney disease, heart disease, anaemia, and mental disorders presented with loosened prosthesis, thinning of medial proximal cortex of the femur which had broken within few months after surgery. She complained of painful walking at left hip joint. There was also evidence of chronic infective and degenerative arthritis of acetabular component of the affected hip joint. Cemented revision total hip replacement surgery was performed with expert multidisciplinary involvement. On 2nd postoperative day the patient was allowed to walk on operated limb with the aid of walker. On 12th postoperative day all the stitches were removed and wound was found healthy. DOI: http://dx.doi.org/10.3329/dmcj.v1i2.15920 Delta Med Col J. Jul 2013;1(2):58-61

Download Full-text

SHALL IT BE BETTER, AS AN APPROACH FOR THR, POSTERIORLY OR LATERALLY; A CLINICO-FUNCTIONAL AND GAIT ANALYTICAL OUTCOME ANALYSIS, IN A PROSPECTIVE STUDY, IN THE SOUTH-INDIAN POPULATION.

10.36106/7014294 ◽

2021 ◽

pp. 71-75

Author(s):

Arun Kumar C ◽

Ganashree S ◽

Arivoli S ◽

Aswath C A ◽

Rakesh Kumar B ◽

...

Keyword(s):

Prospective Study ◽

Total Hip Replacement ◽

Hip Replacement ◽

Posterior Approach ◽

Lateral Approach ◽

Harris Hip Score ◽

South Indian Population ◽

Total Hip ◽

South Indian

Introduction: Hip resurfacing arthroplasty (HRA) or Total hip replacement (THR), as it is popularly called, attempts to mollify these basic clinical problems, in patients with a hip arthritic problem, which may be of a sequela to age-related degeneration, osteonecrosis, systemic disorder like Rheumatoid arthritis (RA) or Ankylosing spondylosis (AS) or as a result of trauma and or an old infection. The basic pathology, is an unfavourable and abrading hip diarthrodial joint. The endeavour of the study was, to establish the efcacy of the Posterior vs Lateral approach for THA/THR, by studying their outcomes in primary THR. This prospective study was undertaken at Che Materials And Methods: ttinad Hospital and Research Institute (CARE), Kelambakkam, Chengalpattu district, Tamilnadu, In the Department of Orthopaedics from Jan 2017 to Dec 2020 (48 months). The Functional outcome of hip surgery was measured using the Harris Hip Score, Oxford hip score and the WOMAC. Rivermead visual gait analysis (RVGA) method was used post-operatively to assess the gait. The Biomechanical outcomes of Abductor Gait Component, were individually assessed by EMG studies. The Harris Hip Score, The Oxford Hip S Results: core and WOMAC score, when the lateral approach was compared to the posterior approach pre-op and post-op in the 12 months minimum follow-up period, the laterally approached group faired better. The VAS score was equivocal. The comprehensive RVGA assessment also showed marginally better results for the laterally approached group as was the case with the Trendelenburg test score. The EMG studies for the Gluteus Maximus, Medius and the lateral rotators of hip also favoured the outcomes for the laterally approach hips. The supremacy of the Lateral Approach, ove Conclusion: r Posterior Approach, cannot be adjudged in a short-term follow-up study. It is thus opined that the Lateral Approach may be statistically and data wise superior, but the patient satisfaction, which is a major factor, is almost the same in both the approach groups. The follow-up needs to be atleast for a decade for us to be able to come to any meaningful conclusion. With regards to surgery like the Total hip replacement, which have a longevity factor exceeding 10 years, studies have to be followed up for periods in excess of 10 years.

Download Full-text

NON CEMENTED BIPOLAR HEMI-ARTHROPLASTY, SURGICALLY INTERVENED FOR GERIATRIC FRACTURES OF NECK OF FEMUR, THAT ARE DISPLACED: A PROSPECTIVE CASE SERIES STUDY.

10.36106/3037389 ◽

2021 ◽

pp. 73-76

Author(s):

Arun Kumar.C ◽

Arun Kumar KV ◽

Ashwanth Narayan B ◽

Venkatachalam K ◽

Saran Karthik S ◽

...

Keyword(s):

Prospective Study ◽

Total Hip Replacement ◽

Hip Replacement ◽

The Elderly ◽

Transfusion Rate ◽

Complication Rates ◽

Neck Of Femur ◽

Total Hip ◽

Hemi Arthroplasty

Fracture neck of femur which are displaced, do not nd a place in the elderly where the head can be preserved even if there is a surgical intervention. Fixation devices like the DHS have time and again failed to satisfactorily treat these fractures. It's here that the Bipolar Hemi Arthroplasty comes to us, as a very handy operative tool. The question is, whether or not the stem of the Bipolar, be cemented or not. The problems of cementation in the elderly carries the risk of BCIs – the bone cementing implantation Syndrome; which can at times be fatal. Cementation makes, future needed Total Hip Replacement, more difcult. In this prospective study of patients conducted at Chettinad Hospital and Research Institute, Kelambakkam, South India ; we have chosen an age group between 61 to 75 years, with an inclusion criterion satisfying type III or IV Garden, but also at the same time, be classiable, as a type A or type B DORR's classication. Our male to female ratio was 1:2 the mean age was 68.5 years and 93.3% (n=84) of patients undergoing un-cemented Hemi-Arthroplasty, when graded by HHS were either Excellent or Good. We had no Poor outcomes in our study. Our minimum follow up was for 12 months, with a mean follow up of 23.5 months. All our cases were done by the Southern Moore's approach, with an average duration of surgery at 82 minutes. The blood loss on an average was 285 ml and the average blood transfusion rate was at 1.8 units. The average post operative stay was for 12 days. From this short-term prospective study, we concluded that Un-Cemented Hemi-replacement Arthroplasty gives Good to Excellent clinico-functional outcomes. It also does not cause any hindrance, if future Total Hip Replacement, is required. Our complication rates were also manageable, with only about 6.7% (n=6) patients, needing revision surgery due to stem loosening.

Download Full-text

Complications in Hip Arthroplasty

N.N. Priorov Journal of Traumatology and Orthopedics ◽

10.17816/vto201118359-63 ◽

2011 ◽

Vol 18 (3) ◽

pp. 59-63 ◽

Cited By ~ 3

Author(s):

Aleksandr Borisovich Slobodskoy ◽

E Yu Osintsev ◽

A G Lezhnev ◽

A B Slobodskoi ◽

E Yu Osintsev ◽

...

Keyword(s):

Total Hip Replacement ◽

Hip Joint ◽

Hip Replacement ◽

Joint Arthroplasty ◽

Total Hip ◽

Inflammatory Processes ◽

History Of ◽

Revision Total Hip Replacement ◽

Joint Arthroplasties

Experience in follow up of 1399 patients after 1603 hip joint arthroplasties is presented. Bilateral operations were performed in 102 patients. In 111 patients revision total hip replacement was performed. Age of patients ranged from 18 to 94 years. Different complications were present in 4,3% of cases: pyo-inflammatory - in 1,37%, implant head dislocation - 1,93%, periprosthetic fractures - 0,19%, postoperative neuritis - 0,49% and pulmonary thrombosis - in 0,31% of cases. Elderly and senile patients, severe concomitant pathology (diabetes mellitus, rheumatoid arthritis and other systemic diseases), acute proximal femur injury, earlier operated dysplastic coxarthrosis, revision and complicated total hip replacement, history of pyo-inflammatory processes in the zone of hip joint are to be considered as risk factors to complication development. Scale for complications prognosis in hip joint arthroplasty is presented.

Download Full-text

Posturographic methods for body posture symmetry assessment

Bulletin of the Polish Academy of Sciences Technical Sciences ◽

10.1515/bpasts-2015-0103 ◽

2015 ◽

Vol 63 (4) ◽

pp. 907-917 ◽

Cited By ~ 1

Author(s):

T. Łukaszewicz ◽

D. Kania ◽

Z. Kidoń ◽

K. Pethe-Kania

Keyword(s):

Total Hip Replacement ◽

Hip Replacement ◽

Center Of Pressure ◽

The Body ◽

External Stimulation ◽

Total Hip ◽

Replacement Surgery ◽

Hip Replacement Surgery ◽

Static Posturography

Abstract The article presents a number of posturographic methods enabling objective postural symmetry assessment in patients undergoing rehabilitation after total hip replacement surgery. The key goal of such rehabilitation is fast restoration of a proper body weight distribution. The postural symmetry measures proposed in the article enable generalized quantification of the CoP (Center of Pressure) trajectories measured during standard static posturography diagnostics and the so-called follow-up posturography examination. The follow-up posturography is a relatively new but promising method of physical rehabilitation. All of the herein discussed posturographic measures have been designed specifically to quantify postural symmetry either in a standing and relaxed upright position, in the absence of any deterministic external stimulation (static posturography) or in the presence of a visual biofeedback stimulation enforcing the coordinated slow swaying movements of the body (the follow-up posturography). The experimental results presented in this paper constitute the outcome of the long-term cooperation between the Institute of Electronics of the Silesian University of Technology and the Silesian Rheumatology and Rehabilitation Hospital. The usefulness of the proposed postural symmetry measures has been verified in a series of clinical trials carried out in a selected group of patients undergoing rehabilitation after total hip replacement surgery.

Download Full-text

Faculty Opinions recommendation of Internal fixation compared with total hip replacement for displaced femoral neck fractures: a minimum fifteen-year follow-up study of a previously reported randomized trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718319356.793521355 ◽

2016 ◽

Author(s):

Mark D Neuman

Keyword(s):

Femoral Neck ◽

Internal Fixation ◽

Randomized Trial ◽

Total Hip Replacement ◽

Hip Replacement ◽

Femoral Neck Fractures ◽

Total Hip ◽

Follow Up Study ◽

Displaced Femoral Neck Fractures

Download Full-text

Uncemented versus cemented arthroplasty after metal-on-metal total hip replacement in patients with femoral neck fractures: a retrospective study

Journal of International Medical Research ◽

10.1177/03000605211012210 ◽

2021 ◽

Vol 49 (5) ◽

pp. 030006052110122

Author(s):

Wenlu Liu ◽

Huanyi Lin ◽

Xianshang Zeng ◽

Meiji Chen ◽

Weiwei Tang ◽

...

Keyword(s):

Femoral Neck ◽

Clinical Outcomes ◽

Total Hip Replacement ◽

Hip Replacement ◽

Femoral Neck Fractures ◽

Harris Hip Score ◽

Complication Rates ◽

Total Hip ◽

Metal On Metal

Objective To compare the clinical outcomes of primary metal-on-metal total hip replacement (MoM-TR) converted to uncemented total hip replacement (UTR) or cemented total hip replacement (CTR) in patients with femoral neck fractures (AO/OTA: 31B/C). Methods Patient data of 234 UTR or CTR revisions after primary MoM-TR failure from March 2007 to January 2018 were retrospectively identified. Clinical outcomes, including the Harris hip score (HHS) and key orthopaedic complications, were collected at 3, 6, and 12 months following conversion and every 12 months thereafter. Results The mean follow-up was 84.12 (67–100) months for UTR and 84.23 (66–101) months for CTR. At the last follow-up, the HHS was better in the CTR- than UTR-treated patients. Noteworthy dissimilarities were correspondingly detected in the key orthopaedic complication rates (16.1% for CTR vs. 47.4% for UTR). Statistically significant differences in specific orthopaedic complications were also detected in the re-revision rate (10.3% for UTR vs. 2.5% for CTR), prosthesis loosening rate (16.3% for UTR vs. 5.9% for CTR), and periprosthetic fracture rate (12.0% for UTR vs. 4.2% for CTR). Conclusion In the setting of revision of failed primary MoM-TR, CTR may demonstrate advantages over UTR in improving functional outcomes and reducing key orthopaedic complications.

Download Full-text