Online ISSN: 2515-8260

Keywords : Total hip arthroplasty

Outcome assessment of total hip arthroplasty patients with limb length discrepancy

Dr. Sarang Shete, Dr. SK Saidapur, Dr. Ravi Jatti, Dr. Kiran Patil

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 2040-2046

THA is a successful orthopaedic intervention & the procedure has relieved pain of many patients, yet some of them remain unsatisfied & has some complications which has least mortality but could have quite reasonable discomfort, especially in initial rehabilitation periods. Difference in the limb length is one among them & this LLD (limb length discrepancy) can persist permanently in these few. Understanding this effect on patients satisfaction is an important aspect.
Thus, in this research we aimed at understanding the outcome of THA patients assessed by using PROM-Patient reported outcome measurement tools like Harris Hip score (HHS) & X- Ray based measurements of change in LLD before & after surgery.
In this prospective study of 6 months follow up of each individual patients of uninfected aetiology & patients above 18 years of age irrespective of gender, we studied 45 hips in total 42 patients. All of them underwent Total Hip Replacement for various reasons of painful end stage arthritis or fractures of hips, with one third young patients having age less than 40 years.
In terms of negative results, only one THA was restored to same LLD from preop to post op (i:e 0 mm to 0 mm-zero to zero) as compared to other 44 Total hips, where change in LLD was observed as inevitable event in a range from 0 to 40 mm LLD in preoperative restored to range of 0 to 20 mm of LLD in the post operative period

Short Term Outcome of Large Diameter Head In Uncemented Total Hip Arthroplasty 10 Years Outcome Evaluation

Jagannath Desai, Manjunath N, Nagadurga Prasanna Reddy N

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2521-2529

Background: The normal mechanical function of the hip is substantially altered by a variety of disorders. The surgical treatment of such conditions, particularly by hip replacement offers an opportunity not only to replace the articular surface of joint, but also to improve the long term mechanical function by decreasing the load on the joint. Objective: To evaluate short term outcome of large diameter head in uncemented total hip arthroplasty.
Materials and Methods: This study was done in the outpatien and emergency Department of Orthopaedics, Pt. B.D.S.  P.G.I.M.S. Rohtak.  Duration of study period was from January 2010 to June 2020.
Results: 14 cases (58.33%) had avascular necrosis of head of femur, 5 cases (20.83%) had osteoarthritis, one patient had rheumatoid arthritis. 15 patients (60%) were operated on left side, while 8 (32%) were operated on right side and 1 (8%) case was operated on both sides. Metal-on-metal THR was done in 8 cases (32%), Metal-on-polyethylene THR was done in 17 cases (68%) and Ceramic-on-ceramic was done in none. Postoperative pain was absent in 15 patients (60%), mild pain was seen in 9 patients (36%) and moderate pain in one patient (4%).
Conclusion: Total hip arthroplasty continues to be an ideal procedure for achieving painless, mobile, stable hip in cases with advanced hip disorders.

Dual mobility total hip arthroplasty in osteonecrosis of femoral head: Is it suitable for Indian population?

Chirag Patel, Parth Patel, Baiju Patel, Saral Patel

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 929-934

Background &Aim: Dual Mobility Total Hip Arthroplasty (DMTHA) is a reasonable
treatment option for osteonecrosis of femoral head (ONFH), especially in active young
patients who are at an increased risk of dislocation post-surgery. Moreover, lifestyle a
religious habits of Indian patients require extreme flexion and rotation, making DMTHA a
lucrative treatment option. The aim of our study is to evaluate the short-term results of
DMTHR for ONFH in the Indian population and their ability to resume their daily activities
after the surgery.
Material and Method: The study is a retrospective analysis of 23 DMTHA in 17 patients
who underwent DMTHA for ONFH between March 2018 to March 2020 and with a
minimum follow-up of one year. Patients were evaluated clinically using Harris Hip Score
(HHS) and Patient-Reported Outcome Measures (PROMs), such as the ability to squat and sit
cross-legged. Radiological evaluation was performed to detect implant migration, loosening,
periprosthetic osteolysis, or heterotrophic ossification.
Result: In our study, the mean age of patient was 36.7±9.1 years. The mean pre-operative
HHS scores of 53.8±15.4 improved to 97.0±4.2 at one year post-surgery. 94.1% patients in
our study could squat and sit cross-legged at a mean duration of 3.2 months post-surgery.
Conclusions: The use of DMTHA in Indian patients with ONFH showed good early clinical
and functional results without major complications, and simultaneously meeting their high
functional and cultural requirements

A randomized comparative study to assess blood loss in patients undergoing total hip arthroplasty with and without the use of tranexamic acid

Dr. Saurabh KP, Dr. Sunkappa SR, Dr. Karthik B, Dr. Rameshkrishnan K, Dr. Ramesh Krishna K

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2380-2387

Background: Total hip arthroplasty could be associated with major intra-operative as well as post-operative blood loss. Post-operative anaemia is a recognized complication which can prolong hospital stay, delay rehabilitation and is poorly tolerated by elderly patients. Blood transfusion carries the risk of infections, anaphylaxis, etc. We examined whether tranexamic acid given before and after total hip arthroplasty reduces intra-operative, post-operative and total operative blood loss and whether the need for post-operative blood transfusion is reduced.
Materials & Methods: A total of 40 patients were included in this study. Group A (n=20, study group) received I.V tranexamic acid (15mg/kg body weight) infusion 10 minutes before incision. 4 hours later, 10mg/kg body weight I.V tranexamic acid was given. Group B (n=20, control group) did not receive any anti fibrinolytic agent. The amount of blood loss, post-operative drop in haemoglobin and the amount of blood transfused was recorded in each case.
Results: Tranexamic acid significantly reduced intra-operative blood loss by 35.68% and total operative blood loss by 22.87% with a 30% reduction in blood transfusion rates compared to the control group. There was no significant effect on post-operative blood loss, duration of surgery or length of hospital stay.
Conclusion: Tranexamic acid when administered perioperatively significantly reduces the operative blood loss in primary total hip arthroplasty surgery with minor side effects. Thus, it can be used effectively in patients undergoing primary total hip arthroplasty to reduce intra-operative blood loss and the need for blood transfusions.

Assessment of Hip Osteoarthritis after Cementless Total Hip Arthroplasty

Salem Farag Salem Ali; Elsayed El-Etwey Soudy; 2Reda Hussein El-Kady; Fahmy Samir

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1023-1030

The purpose of hip arthroplasty is to restore function by restoring normal anatomy and thus normal hip biomechanics. The aim of the present study was to evaluate the clinical and radiologic outcomes of young patients with degenerative osteoartheritis who have a total hip arthroplasty (THA). Patients and methods: This retrospective study wasconducted in Orthopedic Surgery Department, Faculty of Medicine, Zagazig University on 18 patients with degenerative osteoarthritis. Patients with significant disabling hip pain and moderate to severe functional limitation of activities of daily living due to osteoarthritis of the hip joint with any of the etiologies. Clinical assessment was done byusing Harris Hip Score at 6 weeks, 3 and 6 months follow up, also we used radiographs in analyzed with reference to signs of loosening at end of 3 months and 6 month. Results: Mean of pain score improved from marked pain (10.1±8.26) to slight pain (38.7±5.04) post- operative. Mean Walk score improved from (1.1±1.02) pre-operative to (9.3±1.53). Post- operative. Mean of Support score improved from (1.9±1.1) pre-operative to post- operative (7.8±2.39). Limping improved from moderate limping (2.2±2.6) pre-operative to (9±1.45) postoperative. Mean climbing upstairs score in most cases improved from (0.55±0.51) pre-operative to (1.9±0.32) post- operative. A statistically significant increase in points of all parameters postoperative. Wear Shoes stocks score improved from (2±0) to (3.1±1.02) post- operative, sitting improved from (1.6±1.53) to sit comfortably to any chair for one hours (4.3±0.97) postoperative. Mean of uses public transportation increased to be postoperative 0.78±0.43 and deformity improved to be 3.1±0.58.Range motion improved to do normal motion range post- operative. Conclusion: Cementless total hip arthroplasty has reassuring results in patients <50 years of age. It is not associated with any significant early or late complications and has outstanding functional outcomes. Patients usually do not experience any pain, limping, difficulty in walking and attain normal limb length. They develop no restriction in the range of movement

Impact of Dynamic balance training on hip musculature moments and stability index in programming total hip arthroplasty

Magdy M.A. Shabana; Ahmed Assem Abd El Rahim; Nadia Mohamed Abdelhakiem; Mohamed Ibrahim Mabrouk; Mohamed M. M. Essa

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 839-849

Aging impairs the central nervous system capability to process vestibular, visual and proprioceptive signals responsible for maintaining body balance. Total hip replacement (THR) is a procedure, which can improve the quality of life in osteoarthritic patients. However, dynamic stability deficits and impairment in lower limb can be observed for several months after the procedure. Purposes: to investigate the effect of dynamic balance training and traditional rehabilitation on hip musculature moments, and stability index in unilateral total hip arthroplasty programming.