KẾT QUẢ PHẪU THUẬT THAY KHỚP HÁNG TOÀN PHẦN ĐIỀU TRỊ HOẠI TỬ VÔ KHUẨN CHỎM XƯƠNG ĐÙI TẠI BỆNH VIỆN QUÂN Y 121

Abstract

Background: Osteonecrosis of the femoral head is a progressive condition caused by disrupted blood supply, leading to femoral head collapse and hip joint destruction. In advanced stages, Total Hip Arthroplasty is considered an effective treatment to alleviate pain and restore joint function. However, data regarding treatment outcomes in Vietnam remain limited. Objectives: To describe the clinical and radiological characteristics and evaluate the treatment outcomes of total hip arthroplasty in patients with osteonecrosis of the femoral head. Materials and Methods: A prospective cross-sectional descriptive study was conducted on 35 patients diagnosed with osteonecrosis of the femoral head who underwent total hip arthroplasty at Military Hospital 121 from August 2024 to August 2025. Study variables included age, sex, etiology, Ficat–Arlet classification, Harris Hip Score (HHS), Visual Analogue Scale (VAS) for pain, and postoperative complications. Results: The mean age of the patients was 51.57 ± 11.27 years with a male-to-female ratio of 7.7:1. All patients presented with progressive hip pain and restricted range of motion. Radiographic findings showed that Ficat–Arlet Stage IV accounted for 82.86% of cases. The mean HHS significantly improved from 48.74 ± 11.97 preoperatively to 89.49 ± 6.31 at the 6-month postoperative follow-up. The mean VAS score decreased from 6.94 ± 1.21 to 0.69 ± 1.02. The rate of good and excellent outcomes reached 94.29%. No cases of prosthetic dislocation, stem loosening, or clinically significant limb length discrepancy were recorded. Conclusion: Total hip arthroplasty is a safe and highly effective treatment for advanced osteonecrosis of the femoral head, significantly improving hip function and providing substantial pain relief with a very low complication rate.