Assessing functional outcome using modified Harris hip score in patients undergoing total hip replacement

Background: Total hip replacement (THR) is the most successful and cost effective treatment with aim of pain relief and functional rehabilitation for hip disorders. As the implant designs of THR have evolved over time, the functional outcome and survivorship has improved. Even after so many advancements, it remains unclear that which implants are better, uncemented or cemented. Hence, we took up this study to analyze which of the uncemented or cemented THR have better functional outcome.Methods: This was a longitudinal study conducted during 2014 to 2018. Hundred cases were randomized into groups of 50 each. All patients with age between 55-80 years in whom THR was indicated were included in the study. Uncemented THR was done in Group A and cemented THR was done in Group B. Patients were followed up at 12 weeks, 6 months, 12 months, and 3 years. At follow-up, functional examination in terms of visual analogue scale (VAS) score and Harris hip score (HHS) was done.Results: The mean age of patients in Group A (uncemented) and Group B (cemented) was 62.5 years and 60 years respectively. We found that the difference of VAS score and HHS between Group A and B was statistically significant at 12 weeks and 6 months. The difference of VAS and HHS scores between Group A and B at 12 months and 3 years was not significant.Conclusions: We conclude that cemented THR has better functional outcome at short term. They are cost effective option at age ≥55-60 years.

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Functional outcome of total hip replacement using a short stem implant

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20191782 ◽

2019 ◽

Vol 5 (3) ◽

pp. 449

Author(s):

Rajiv Kapila ◽

Mukand Lal ◽

Preeti Takkar Kapila

Keyword(s):

Total Hip Replacement ◽

Hip Replacement ◽

Stress Shielding ◽

Thigh Pain ◽

Short Stem ◽

Harris Hip Score ◽

Total Hip ◽

Post Operative Period ◽

Modified Harris Hip Score

Background: Conventional cementless THA is associated with stress shielding of the proximal femur and thigh pain. Short femoral stem can conserve bone, reduce stress shielding in the femur and reduce thigh pain. The present study aims to describe the functional outcomes associated with short stem metaphyseal implant in THA in our department.Methods: This prospective study was conducted in the Department of Orthopaedic Surgery, Indira Gandhi Medical College, Shimla among patients who needed THA for painful disabling hip. Modified Harris hip scores (HHS) were assessed for all patients pre-operatively and at their final follow up.Results: During the study period, a total of 20 patients were included in the study, 20% of them were females. The most common indication for THA was avascular necrosis head of femur with secondary osteomyelitis (n=14), of which 12 cases had excellent Hip Harris Score while two were in good category. Modified Harris hip score was excellent in patients where early partial and full weight bearing was started. Per-operatively, there was only one complication of fracture greater trochanter which was fixed with cerclage wire. In early post-operative period, two cases of superficial infection were noted and one case of varus malposition was present. In late post operative period, there were three cases of varus malposition and one case of deep infection as sinus.Conclusions: Total hip replacement with short anatomical metaphyseal loading stem improved the modified Harris Hip score significantly, with very few complications. Future multicentric studies are needed to evaluate the efficacy of short stem implants over a long follow up period.

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Management and Outcome of Patients With Femoral Head Fractures: Injuries and Associated Prognostic Factors

10.21203/rs.3.rs-141488/v1 ◽

2021 ◽

Author(s):

Sujan Shakya ◽

Jialei Chen ◽

JiaChen Sun ◽

Zhou Xiang

Keyword(s):

Femoral Head ◽

Total Hip Replacement ◽

Hip Replacement ◽

Functional Outcomes ◽

Fixation Method ◽

Harris Hip Score ◽

Femoral Head Fracture ◽

Total Hip ◽

Surgical Methods ◽

Modified Harris Hip Score

Abstract Objective: Femoral head fractures are rare injuries that are often associated with poor functional outcome and complications. Fracture management and surgical methods for these fractures are variable. The purpose of this study was to evaluate the incidence, treatment methods and approaches, complications and functional outcomes of femoral head fractures.Methods: We conducted a retrospective review of fifty patients who sustained femoral head fractures from January 2011- December 2018. There were thirty-seven males and thirteen females with median age of 40 years. A surgical approach and fixation method were recorded. Patients were classified according to the Pipkin Classification system. Clinical results were evaluated for patients with two years or greater follow-up using the Modified Harris Hip Score (MHHS). Results: Eight patients (16%) were managed successfully with closed reduction without surgery and thirty-seven (74%) patients required operative reduction and internal fixation (ORIF) of the femoral head and acetabulum, 5 (10%) patients required immediate Total Hip Replacement (THR). Six (12%) developed AVN, four (8%) requiring secondary total hip replacement (THR). Sixteen patients (33%) developed PTA, eight (16%) developed HO and six patients (12 %) had sciatic nerve injury, none requiring operative treatment. Overall functional results, according to modified Harris hip score were excellent in two (4%) patients, good in sixteen (32%) patients, fair in twenty-two (44%) patients, and poor in ten (20%) patients. A statistically significant difference in outcome was observed among four pipkin subtypes. Conclusion: Femoral head fracture are a rare injury that are often associated with poor outcome. In this study we report the functional outcomes and complications of all treatment approaches for femoral head fracture based on Pipkin classification. This study, adds to the growing literature on femoral head fractures and provide reference for the clinical treatment to guide patient management.

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TO EVALUATE EFFECT OF HORIZONTAL HIP OFFSET AND LEG LENGTH RECONSTRUCTION ON FUNCTIONAL OUTCOME OF TOTAL HIP REPLACEMENT

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i10.1455 ◽

2020 ◽

Vol 4 (10) ◽

Author(s):

Harshit Jain ◽

Hemraj Saini

Keyword(s):

Clinical Outcome ◽

Regression Model ◽

Functional Outcome ◽

Total Hip Replacement ◽

Hip Replacement ◽

Harris Hip Score ◽

Leg Length ◽

Hip Geometry ◽

Total Hip ◽

Geometry Reconstruction

Background: For total hip replacement besides long term durability a optimal postoperative functional outcome is essential.so aim of this study was to determine the combined influence of hip geometry reconstruction on the clinical outcome following primary total hip replacement for unilateral osteoarthritis. Methods: A hospital based prospective study was carried out on 60 cases of unilateral osteoarthritis with normal contralateral hip. We prospectively assessed the clinical outcome and radiographic parameters for hip geometry reconstruction using validated measurements for the operated hip compared to the contralateral native hip with primary unilateral THA. The correlation of reconstruction parameters was investigated using a multivariate polynomial regression model for the dependent variable ?HHS (difference between the Harris hip scores preoperatively and 6 months postoperatively). Target zones for hip reconstruction were investigated for an association with superior clinical outcome. Results: The regression model demonstrated a significant correlation for the ?HHS and both hip offset (HO) reconstruction and leg length difference. Patients with accurate to slightly increased HO reconstruction combined with balanced leg length demonstrated a significantly higher ?HHS than patients outside this zone. Conclusion: HO and leg length reconstruction demonstrated an additive effect on clinical outcome and surgeons should aim for high accuracy in the reconstruction of both factor. Keyword: Hip offset, total hip arthoplasty, harris hip score

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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.

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Total hip replacement: increasing femoral offset improves functional outcome

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-016-2527-4 ◽

2016 ◽

Vol 136 (9) ◽

pp. 1317-1323 ◽

Cited By ~ 18

Author(s):

N. D. Clement ◽

R. S. Patrick-Patel ◽

D. MacDonald ◽

S. J. Breusch

Keyword(s):

Functional Outcome ◽

Total Hip Replacement ◽

Hip Replacement ◽

Femoral Offset ◽

Total Hip

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Preoperative Quadriceps Strength as a Predictor for Short-Term Functional Outcome After Total Hip Replacement

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2010.10.015 ◽

2011 ◽

Vol 92 (2) ◽

pp. 236-241 ◽

Cited By ~ 28

Author(s):

Marije S. Holstege ◽

Robert Lindeboom ◽

Cees Lucas

Keyword(s):

Functional Outcome ◽

Total Hip Replacement ◽

Hip Replacement ◽

Quadriceps Strength ◽

Short Term ◽

Total Hip

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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.

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