[Differences in hip prosthesis implantation in a non-urban region]

The aim of the study was to analyse differences of early results after total hip replacement performed at various hospitals.

A total of 37 consecutive patients submitted for postoperative rehabilitation were examined. These patients were referred from 18 different hospitals. In an assessment sheet, personal data, age, indication, operating department (surgical or orthopedic), side, length of skin incision and early X-ray presentation with regard to cup angle, position of greater trochanter in relation to head of prosthesis, varus/valgus angle of femoral prosthesis, and cementation were recorded.

Of the 37 patients, 26 were female, 11 male. Average age was 62.9 +/- 10.4 years. Degenerative osteoarthritis was present in 23 cases, fractures in 6 cases, there were 6 patients with osteoarthritis following hip dysplasia, 1 pathological fracture, and 1 aseptic necrosis of the femoral head. The skin incision length varied from 8 to 31 cm, averaging to 16.8 +/- 5.3 cm. Implantations were cementless in 20 cases, cemented in 12, and partly cemented in 5 cases. Using a THR-Early-Result-Score of 25 points maximum, # 7 implantations were scored as normal, 16 subnormal, 10 atypical, and 4 highly atypical.

The data presented show an incidence of 81% non-ideal implantations which is considered surprisingly high. Potential reasons are discussed. It is suggested that efforts to improve the quality of total hip replacements should be made.