A study of functional outcome in young arthritic hip undergoing uncemented total hip arthroplasty

Author(s): Avik Sarkar, Ravi Bhanushali, Vikram Chauhan, Umesh Nagrale and Prasannaditya Muzumdar

Abstract: There has been an increase demand of Total hip arthroplasty in young patients, however long-term results are expected to be inferior. To determine the efficacy of total hip replacements in population, the current authors reviewed the long-term results of patients who were 50 years and younger & who had cementless total hip arthroplasties at our institution, and reviewed the literature on total hip arthroplasty in younger patients. Material and Methods: In our study we prospectively studied 35 young cementless total hip arthroplasties in 25 patients who were operated from June 2014 to May 2016. Majority of patients were in the age group of 41-50 years with Male to female ratio of 2:1. 23(92%) patients operated had moderate to highly physically active life style. The main indication was - avascular necrosis of hip (68%) followed by arthritis (16%). 10 patients (60%) were operated on both sides. Modified Gibson's approach was used in all cases. In all the patients, the type of femoral and acetabular prosthesis was uncemented, either Corail with Duraloc system or solution stems or pinnacle hip systems or ceramic on ceramic type. Of the 25 patients of cementless total hip arthroplasties performed in our study, 2 were of ceramic on ceramic variety, 1 patient was treated with solution femoral reconstruction system, and 3 patients were treated with pinnacle hip system, while the remaining majority of the patients, 19 were treated with Corail with Duraloc hip systems. Follow up ranged from 6 months to 24 months, average follow up of 12 months. 2 patients had dislocation of the cementless total hip arthroplasty components, 1 patient had DVT, 1 patient had sciatic nerve injury and 1 patient showed acute postoperative infection. Average acetabular cup size was 50mm while the most common femoral stem size was size 11. All patients (96%) had no pain on follow up except 2 patients had slight pain. All patients had no limp. 6 patients used cane for long walk distance, 5 patients were able to walk for 1 kilometer and rest were able to walk unlimited. Average flexion was 110°, abduction 40°, adduction 30°, external rotation 30°, internal rotation 20°. All 25 cases (100%) had no significant limb length discrepancy (>3.2cms) post-operatively. 96% excellent results was achieved according to modified Harris Hip Score. 1 patient had good outcome probably attributable to his systemic illness. Conclusion: Cementless Total Hip Arthroplasty is a procedure which provides a nearly physiological joint and with experience, proper instrumentation, proper selection of implants, its placement in correct version and inclination, excellent results could be achieved with nil or minimal complication rate.

DOI: https://doi.org/10.22271/ortho.2017.v3.i3k.113