Function Outcome Analysis with regards to Cup Inclination, Femoral and Acetabular Versions in Total Hip Arthroplasty

Sugumar, G N (2020) Function Outcome Analysis with regards to Cup Inclination, Femoral and Acetabular Versions in Total Hip Arthroplasty. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION: Acetabular and femoral components positioning is critical to a successful total hip arthroplasty. This dissertation examines 35 hips to study the effect of acetabular and femoral components position and reported patients outcome using Harris hip score. AIM OF THE STUDY: To analyze the functional outcome in total hip arthroplasty patients in relation to cup positioning and femoral versions by radiologically by CT measurements and clinically by Harris hip score. MATERIALS & METHODS: Patients admitted for total hip arthroplasty (cemented and uncemented) without associated lower limb fractures or other factors like arthritis knee etc. All patients will undergo X ray pelvis with both hip, CT hip post operatively for clinical and radiological assessment. Preoperative clinical examination is recorded and Harris hip score is done. Patients are counselled regarding advantages, disadvantages and possible complications of this procedure and a written consent is obtained. INCLUSION CRITERIA: Age >18 years, Isolated neck of the femur – Avascular necrosis of femoral head, Non-union neck of the femur, displaced fractures neck of femur, monoarticular arthritis hip etc. EXCLUSION CRITERIA: Patients with congenital deformities of hip, those with cognitive impairments affecting their ability to follow instructions, unable to walk, patients with lower limb neurovascular damages, medical comorbidities, age <18 years. Design of study is both prospective and retrospective analytical study. RESULTS: Excellent outcome 40%, Good outcome 49%, Poor outcome 11%. DISCUSSION: Absolute and relative acetabular position was found to be weakly correlated with functional outcomes but the results are not clinically significant. While specific intraoperative targets for acetabular position may be important for hip stability, there may be no change in patient outcomes. CONCLUSION: In extreme positions (>2SD) acetabular cup remains an important factor in the outcome of total hip arthroplasty which influences the dislocation rate, wear rate, patient outcome. Variation in the positions of the acetabular and femoral components has shown significant correlation radiologically. But within the studied ranges the functional outcome score difference is not clinically significant. Specific intraoperative perfection of safe zones in positioning the acetabular and femoral components may be important for hip stability, but there may be no change in patient outcomes with defining such zones.

Item Type: Thesis (Masters)
Additional Information: 221712008
Uncontrolled Keywords: Acetabular Positioning, Femoral stem version, Total Hip Arthroplasty, Anteversion, Inclination Angle.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 13 Feb 2021 12:52
Last Modified: 13 Feb 2021 12:52

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