Osteoarthritis of the Hip Joint;

Abstract

Objectives: The aim of our study is to determine the surgical outcome andrates of complication in patients undergoing surgical treatment for osteoarthritis of the hip jointwith total hip arthroplasty and compare it with hip resurfacing procedures. Study Design: Aprospective cohort study. Period: Five years duration from January 2011 to December 2016.Setting: Tertiary Care Centre in Karachi, Pakistan. Materials and methods: The study populationconsisted of n= 170 patients (n= 110 patients undergoing cementless THA and n=60 patientsundergoing hip resurfacing procedures). The inclusion criteria was all the patients who came toour outpatient clinic, with unilateral or bilateral osteoarthritis (grade 3,4) of the hip joint requiringsurgical treatment, were fit for surgery and gave informed consent to participate in the study.All the procedures were done by the same team of surgeons at the same institute in seriesunder general anesthesia. Data was collected in a pre-designed proforma. Postoperatively thepatients were restricted to a reduction of weight bearing by half for the first six weeks, andwere involved in physiotherapy till discharge from the hospital. The patients from both groupsreceived the same thromboembolic and infection prophylaxis. Data was analyzed using IBMSPSS version 22. Results: In our study we found that the rates of reoperation had statisticallysignificant differences, being n= 5 in THA group and n=9 in resurfacing group having a pvalue of 0.019. In the resurfacing group n= 4 patients had fractures of the femoral neck. All therevision surgeries were undertaken utilizing the posterolateral approach, n= 2 patients wererevised utilizing cementless femoral stems while n=2 were revised utilizing cemented femoralstem, n= 5 patients were revised to total hip arthroplasty procedure on account of asepticloosening. No dislocations were observed after the revision surgical procedures. There wasno statistically significant difference in the total rates of complications among the two groups,having a p value of 0.44. The pre-operative Harris hip scores were similar in the two groupshaving a p value of 0.2. Conclusion: According to the results of our study the outcome in theboth the cementless total hip arthroplasty and hip resurfacing procedure are similar in termsof implant survival and clinical results however rate of complication is higher in the patientsundergoing hip resurfacing technique and needed revision surgeries. The patients undergoinghip resurfacing had better mobility post operatively, and hence this consideration is to be madeduring patient selection, as hip resurfacing is preferred by younger patients due to its higherfunctional outcomes.