A prospective study to evaluate the clinical and functional outcome of uncemented total hip replacement in avascular necrosis of femoral head in adults

Abstract

Background: Osteonecrosis, also referred to as avascular necrosis (AVN), aseptic necrosis, and ischemic necrosis, is not a specific disease but rather a condition in which a circumscribed area of bone becomes necrotic as a result of a loss of its blood supply. The femoral head is the site most often affected. A number of procedures have been described to accomplish this. Total hip replacement is a reconstructive surgical procedure that provides stability, better quality of life and mobility in patients suffering from hip disorders thus eliminates pain and restore functions of hip. In hip arthroplasty, the acetabulum, femoral head and proximal neck is replaced with metal shell, plastic liner and metal ball.Purpose: To evaluate the clinical, functional, radiological outcome and the complications of uncemented total hip replacement in avascular necrosis of femoral head in adults.Materials and Methods: This prospective study done in the Department of Orthopaedics, Post Graduate Institute of Swasthiyog Prathistan, Miraj, from February 2013 to February 2014. We included the patients of avascular necrosis of femoral head, in the age group of 30 to 60 years.Results: 36 hips of 30 patients with avascular necrosis of femur head who underwent uncemented Total Hip Replacement admitted during above period after evaluating clinically and radiologicallyHarris Hip Score was used to measure the functional outcome. 36.11 % of the patients were found to be in the 50 and above age group, with age ranging from 30 to 60 years and a mean age of 43.8 years. Majority, 27 (75%) were males and 9 (25%) were females. Excellent or good pain relived and function were obtained in 86.01%. The mean total preoperative score was 34.61, which improved postoperatively to a mean score of 90.83. In the scoring system ie, pain, gait, functional activity and ROM, there was a statistically significant improvement (‘p’ value of