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Effect of combined anteversion on outcomes in total hip replacement
Sanjul Bansal1, Amol Kawde1, Abhishek Keshav2
1Department of Orthopaedics, ABVGMC, Vidisha, Madhya Pradesh, India.
Insights
Total hip arthroplasty (THA) significantly improves outcomes for osteonecrosis of the femoral head compared to conservative treatment. THA offers better pain relief, functional recovery, and bone healing in patients with this debilitating condition.
Area of Science:
- Orthopedics
- Bone Biology
- Regenerative Medicine
Background:
- Osteonecrosis of the femoral head (ONFH) is a progressive condition characterized by bone death due to compromised blood supply.
- It primarily affects young adults and often leads to femoral head collapse without intervention.
- Current treatment strategies aim to improve function, alleviate pain, and promote bone healing.
Purpose of the Study:
- To compare the treatment outcomes of total hip arthroplasty (THA) versus conservative management for ONFH.
- To evaluate functional recovery, pain reduction, and radiological union rates over an 18-month period.
Main Methods:
- An analytical cross-sectional study involving 30 patients diagnosed with ONFH.
- Patients were divided into two groups: operative management (THA) and conservative treatment.
- Outcomes were assessed using the Modified Harris Hip Score (mHHS) and Visual Analog Scale (VAS) for pain at 6 and 18 months.
Main Results:
- The THA group demonstrated significantly better functional improvement, with a higher mHHS change compared to the conservative group (p=0.02).
- Patients undergoing THA reported significantly lower pain levels on the VAS at 6 months (p=0.01).
- Radiological union rates were higher in the operative group (95%) versus the conservative group (70%) at 6 months (p=0.04).
Conclusions:
- Total hip arthroplasty provides superior functional outcomes, pain relief, and bone healing for osteonecrosis of the femoral head compared to conservative treatments.
- THA is an effective surgical intervention for managing ONFH, leading to better patient recovery and joint preservation.
Abstract:
Osteonecrosis of the femoral head is a debilitating disease where the bone tissue dies as a result of impaired blood flow, which affects young adults and in most cases, it leads to collapse in the absence of surgical intervention. In this analytical cross-sectional study, 30 patients with osteonecrosis of the femur head were compared to determine the treatment outcomes of operative management using total hip arthroplasty (THA) and conservative treatment over 18 months. Operative group showed considerably better results with a change in Modified Harris Hip Score of 457 to 756 at 6 months compared to 467 to 687 in the conservative group (p=0.02). At 6 months, the operative group (7.2+1.3 to 2.5+0.9) had lower pain than the conservative group (7.5+1.1 to 3.8+1.1) according to Visual Analog Scale (p=0.01). The rates of radiological union were higher in the operative group (95% vs 70% at 6 months, p=0.04), showing that THA offers a far better functional outcome, pain relief and bone healing than conservative treatment of osteonecrosis of the femoral head.
