2018, Volume 4 Issue 1
To assess the 2-year clinical and radiologic results with an entirely HA-coated total hip replacement, with an emphasis on periprosthetic bone remodelling
Author(s): Dr. Varun Chouhan
Abstract: Total hip arthroplasty (THA) is one of the most successful surgical procedures that has been introduced and today over 1.5 million THA’s are performed annually in the world. The development of THA in the 60’s by Sir John Charnley represents a milestone in orthopaedic surgery. The most common indication for THA is primary osteoarthritis, a degenerative disorder of the cartilage and the surrounding tissues. However, 8-9% of the THA’s performed sooner or later need to be re-operated. Revision arthroplasty is a challenging procedure, costly and with a less reliable outcome. The main reason for failure leading to revision is aseptic loosening. Both mechanical and biological effects act in the loosening process, the dominating factor may be one or the other, depending on a number of circumstances, including implant design, fixation mode and technique, as well as biologic factors unique to the individual. Our purpose of this study is to determine the performance of, and periprosthetic bone response to hydroxyapatite (HA)–coated hip implant at least 2 years after insertion. This is both prospective & retrospective study of patients operated with uncemented fully HA coated THR in our institute, Sample size taken is 30 patients of institute who have undergone uncemented fully HA coated THR. We have taken Patients with un cemented fully HA coated THR done, At least 2 year back in hospital as a Inclusion criteria. In exclusion criteria we have excluded Patient with uncemented partially HA coated THR and Patients with anterior thigh pain before operation. Our procedure of study was Clinical follow up of patients pre-op, immediate post op, 12months & 24 months using anterior thigh pain. Radiological follow up through x-rays at pre-op, immediate post op, 12 months & 24 months. Anteroposterior radiographs of the pelvis and femurs cantered over the pubis, and lateral views of the femurs were standardized by using the same film quality, developing process, exposure, target distance, magnification, and field and keeping the leg in the same position. The linear measurements were made by a calliper and corrected for magnification of the radiographs, using the diameter of the head of the femoral component as reference. Femoral zonal analysis was performed on the anteroposterior radiographs as described by Gruen et al. and on the lateral radiographs according to Johnston et al. spot welds that is diaphyseal endosteal bone formation were noted in both anteroposterior and lateral x-rays. Subsidence of the stem was measured by the vertical distance from the lateral shoulder of the prosthesis to the superior tip of the greater trochanter or to the tip of the lesser trochanter. Varus or valgus migration was determined by measuring the angle made by the intersection of a line through the midstem of the prosthesis and a line through the midshaft of the femur as seen on the anteroposterior radiograph. End point of study was completion of clinical and radiological follow up of 30 patients.
Results shown by this study reviews 38 hips in 30 patients who were followed up for a average of 32 months (range 24- 96 months). There were 22 male and 8 female patients. The average age was 41years (range, 14-55 years). The diagnosis was AVN in 28 hips, Ankylosing spondylitis in 7 hips, Fracture neck femur in 2 hips, Koch’s in 1 hip. 6 hips had undergone prior procedures, including osteosynthesis of femoral neck fracture. Clinically Result shows Hip function rose to a near-normal level during the first year, and this result was maintained throughout the study. At 2 years, only 1 patient complained of vague, uncharacteristic hip pain, unrelated to walking. No patient suffered from thigh pain.