Study of Outcome of Total Hip Replacement in Adults with Arthritis in a Teaching Hospital

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Abstract (English)

Aim: Current study aim is to assess the clinical and functional outcomes of cemented Total Hip Replacement in adults using Modified Harris Hip Score in terms of pain, functional disabilities, deformity, range of movements, limb length discrepancy. Method: An observational study carried out on 30 hips of 30 patients who underwent cemented Total Hip Replacement and were available for follow-up. This study conducted on patients with age ranging from 50 – 70 years with mean age of 58.3 years. A thorough clinical and radiological examination was performed. All patients were operated through Hardinge’s direct lateral approach, putting the patient in the lateral position. Quadriceps and knee bending exercises were started immediately post-op. Ambulation training is started with the walker on Day 1-2, followed by gait training with weight-bearing as tolerated on Day 3-7. Full weight bearing on involved extremity can be started on Day 7. Results: 66.7% are males and 33.3% are females underwent Cemented total hip replacement. 13 patients were operated on the left side. Indication for surgery was secondary arthritis due to AVN in 66.7% cases, 3.3% due to ankylosing spondylitis, 6.7% was due to Rheumatoid arthritis which is confirmed by clinical evaluation and blood investigations. The mean follow-up period was 18.8 months. The patients were followed postoperatively at six weeks, 3, 6, 12, and 24 months. 6.7%patients had varus angulation of the stem who complained of anterior thigh pain postoperatively. One patient had a superficial infection that was treated with antibiotics and delayed suture removal. 6.7% patients had leg length discrepancy and shortening who were treated with a shoe raise. All patients were followed up regularly; no patients were lost for follow up. They were evaluated according to the Modified Harris Hip score. The mean total preoperative score was 45.04. The maximum score is 62, and the minimum is 21. Postoperatively the total mean score was 88.44, with 74 being the minimum and 95 being the maximum. The mean follow-up Modified Harris Hip score increased to 91.60, with a minimum of 77 and a maximum of 97. There were a statistically significant improvement p=0.044 (‘p’ value of <0.001) in the follow-up score when compared to the preoperative score. Conclusion: Results showed a significant improvement, wherein 84% had an excellent score, and 8% showed good and 8% fair results. No patient had a poor score. The management of diseased and destroyed hips with cemented total hip replacement is effective and gives stable, mobile, and painless hip joints to the patient. Functional results are excellent, and complications are minimal if done with utmost care and precision. This study has shown that the outcome of the total hip arthroplasty has shown excellent results in terms of pain relief, increased walking distance, and functional capabilities in patients. Most of the patients were elderly active treated with a cemented total hip replacement and have shown excellent clinical and radiological results after an intermediate period of follow-up. The overall functional and clinical outcome showed good results.