Volume 12 | Issue 4 | Oct-Dec 2017 | Page 4-9 | Milind G Kulkarni, Supreet Bajwa, Shrey Singh, Shekhar P Malve, Nitish Arora, Deepak Garg
Authers: Milind G Kulkarni [1], Supreet Bajwa [1], Shrey Singh [1], Shekhar P Malve [1], Nitish Arora [1], Deepak Garg [1].
[1]Department of Orthopaedics, Post Graduate Institute of Swasthiyog Pratishthan, Station Road, Extension Area, Miraj, Maharashtra – 416410.
Address of Correspondence
Dr. Supreet Bajwa
Department of Orthopaedics, Post Graduate Institute of Swasthiyog Pratishthan,
Station Road, Extension Area, Miraj, Maharashtra – 416410.
Email ID: bajwasupreet@hotmail.com
Abstract
Background: Performing primary Total Hip Arthroplasty in young is challenging. The increased physical demands predisposes them to early wear, osteolysis and subsequent loss of fixation. The main purpose of this study is to evaluate the radiological and functional outcome of uncemented and hybrid Total hip arthroplasty with different bearings, in patient less than 50 years of age.
Methods: We retrospectively reviewed all primary Total Hip Arthroplasty (65 uncemented and 19 hybrid) done in our institute from 1997 to 2010. There were 74 patients with 84 Hip joint operated with a mean age 38.37 years at the time of initial THA (range21-49years). Clinical evaluation was done with the help of Harris Hip Score. Radiological evaluation was done using an anteroposterior and lateral xray to look for the radiological loosening, osteolysis, polyethylenewear (eccentric positioning of femoral head), heterotrophic ossification, position of stem and acetabulum cup.
Results: The mean follow up time was 7.62 years with a mean Harris hip score of 87.8 ± 9.02. Mean Harris hip score increases as the age group increases and the results are marginally significant (P-0.09).The overall implant survival rate was 94% with results slightly better in Hybrid group. Ceramic on Ceramic bearing proved significantly (P-0.002) better than ceramic on polyethylene and Metal on polyethylene in 5- 10 year follow up. In 10-20 year follow up ceramic on polyethylene (P-0.009) proved better than metal on polyethylene. We do not have cases of ceramic on ceramic in 10-20 year follow up. Complications included superficial infection, deep infection, Acetabular migration, femoral stem loosening, polyethylene wear, post traumatic dislocation and fracture. All were dealt appropriately.
Conclusion: The present study shows excellent outcome of Total hip arthroplasty in patients younger than 50 years, clinically better as the age advances but that might be because of the confounding effects produced by the systemic conditions in young patients. Ceramic on ceramic bearing proved better in a short term follow up 5-10 years clinically, Ceramic on polyethylene bearing proved better than Metal on polyethylene clinically in a long term follow up. The debate of hybrid versus uncemented needs further studies with large sample size.
KeyWords: Total Hip arthroplasty, Young patients, Hybrid Total Hip Arthroplasty, Uncemented Total Hip Arthroplasty, primary total hip arthroplasty
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| How to Cite this article: Kulkarni M. G, Bajwa S, Singh S, Malve S. P, Arora1 N, Garg D. Functional and radiological evaluation of primary total hip arthroplasty in less than 50 years old- A retrospective evaluation . Journal of Trauma and Orthopaedic Surgery Oct-Dec 2017;12(4):4-9.. |