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Assessment of the outcome of Total Hip Arthroplasty in Displaced fracture Neck of femur: prospective observational study

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Dr. Rakesh Kumar

Abstract

Abstract Aim: The Purpose of this study is to assess the Radiological outcome of Total Hip Arthroplasty in Displaced fracture Neck of femur. Materials and Methods: This prospective observational study was carried out in the department of Orthopaedics, Vardhman institute of medical Sciences,Pawapuri, Nalanda, Bihar, India from Sept 2017 to Sept 2018. Total 80 patients were patients treated with total hip replacement. Radiographic evaluation includes Loosening of the acetabulum and femoral components, Inclination of Acetabular cup, Stem position of femoral component, Vertical subsidence, Migration of the Acetabular cup and Heterotopic Ossification. Modified Harris hip score was used for clinical and functional evaluation of patients. Plain X‐ray pelvis with both hips and proximal femur—AP view and X‐ray of the operated hip lateral view for radiological evaluation. Results: Out of 80, 58 patients were male and 22 female, most of the patients in were above 50 year and followed by 40-50 year. Patients scored 51.25% excellent, 30 good, 8.75% fair and 13.75% patients scored poor. The normal acetabular cup inclination is 30o to 45o. In our study 77.5% neutral, 12.5% vertical and 10% horizontal position were seen. The ideal position of stem of femoral component is central. In this study we had 78.75% central, 12.5% each in valgus and 8.75% varus position. Varus position of the stem may lead to complications such as anterior thigh pain and periprosthetic fractures. There were 2.5% subsidence and 1.25% migration seen and Class II heterotopic ossification was noted in 5 hip, i.e., 6.25 % incidence who underwent THA. We had 4 case of dislocation (5%). The dislocation occurred during the 2 nd month of the surgery at home. Conclusion: we concluded that the total hip arthroplasty gave better results in displaced Intracapsular neck of femur fractures radiologically.

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