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OUTCOMES OF CEMENTLESS TOTAL HIP ARTHROPLASTY IN PATIENTS WITH AVASCULAR NECROSIS OF THE HIP USING A POSTERIOR APPROACH
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Abstract
Objectives: The purpose of this study is to access the outcomes of cementless total hip arthroplasty in patients with avascular necrosis of the hip using a posterior approach. Materials and methods: A retrospective and prospective longitudinal follow-up in 65 patients (80 hips) with a confirmed diagnosis of avascular necrosis of hip with no other associated hip pathologies were included in this study. Demographic features, comorbidities, Arlet - Ficat's class were noted. Cementless acetabular cup with 1-3 cancellous screws and cementless femoral stem were used through Gibson's posterior approach. The patients were checked for early and late complications, the position of acetabular and femoral components by radiography, and overall performance by Harris Hip Score (HHS) over a period of 12 months. Results: The mean age was 54.35 ± 10.15 years. There were 76 (95%) male and 4 (5%) female patients. Nine (11.3%) patients had diabetes mellitus, seven (8.8%) patients had heart disease, eight (10%) patients had lung disease, fifteen (18.8%) patients had liver disease, and forty (37%) patients had no comorbidities. There were 40 (50%) patients in Arlet - Ficat 's class III, 40 (50%) patients in Arlet - Ficat 's class IV. Fifty (81.25%) patients were operated on one side, and fifteen (18.75%) patients bilaterally. No significant early or late complications were noted. Acetabular component was found to be <40o inclined in 8 (10%), 40o-45o inclined in 64 (80%), and >45o inclined in 8 (10%) patients, while femoral component was found neutral in 68 (85%), valgus in 8 (10%), and varus in 4 (5%) patients on radiography at follow-up. On functional assessment, the average HHS of 94.60 ± 5.41, while 63 (78.8%) patients had excellent and 17 (21.2%) patient had a good outcome on HHS. Conclusions: Cementless total hip arthroplasty was a safe and effective option for patients with stage III and IV avascular necrosis of the hip. 100% of patients achieved excellent and very good results. The average Harris score was 94.60 ± 5.41 points.
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Keywords
total hip arthroplasty, avascular necrosis, posterior approach
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