Title: Functional Outcome of Uncemented Total Hip Arthroplasty in Osteoarthritis
Authors: Dr Sudhir Ravindran, Dr Vishnu.S
DOI: https://dx.doi.org/10.18535/jmscr/v8i9.33
Abstract
Total hip replacement is most commonly surgical procedure used to treat joint abnormality due to osteoarthritis and other disorders affecting function of the hip joint.
The best mode of implant fixation in primary total hip replacement (THR) has been a source of debate. Cemented implants achieve stability from cement-bone mechanical interlock, once the polymethylmethacrylate has set, whereas cementless fixation relies on primary press fit stability with long term stability occurring secondary to endosteal microfractures at the time of preparation and subsequent bone on growth or in growth. The optimum fixation choice should be guided by patient-based outcomes, in particular the implant survivorship.
The adverse effects of bone cement led to the popularity of uncemented total hip arthroplasty. Here porous and hydroxy apatite coated components are used. This creates a biological interface called bone ingrowth (osteo integration). Instead of fatiguing and failing of bone cement, this type of fixation continually grows stronger, remodelled and becomes more permanent. The three criteria for bone ingrowth are pores > 40mm in diameter, absence of micromotion, intimacy of porous surface with bone. This study here is to analyze the functional outcome of uncemented THR.
Aim of Study: To study the functional outcome of uncemented total hip arthroplasty.
References
- Learmonth DI, Young C, Rorabeck C. The operation of the century: total hip replacement. The Lancet 2007; 370:1508-19.
- Pettier LF. A history of hip surgery. In Callgan JJ. Rosenberg AG, Rubash HE (Eds). The Adult hip. Philadelphia Lippincott-Raven 1998. pp.3-36.
- Shands AR. Fundamentals in hip surgery. In Tronzo RG (Ed). Surgery of the hip. 2nd edition. New York. Springer-Verlag 1984. pp.1-26.
- White A. Obituary. Lancet 1849; 1:324
- Thompson FR. An essay on the development of arthroplasty of hip. Clin Orthop 1966; 44:73-82.
- Bhan S, Pankaj A. History and evolution of hip arthroplasty. Bhan S, Malhotra R (Ed). Key Issues in Hip Arthroplasty. New Delhi. Mediworld publications 2007. pp.4-10.
- Smith Peterson MN. Evolution of mould arthroplasty of the hip joint. J Bone Joint Surg 1948;30B:59-73.
- Townley CO. Hemi and total articular replacement arthroplasty of the hip with the fixed femoral cup. Orthop Clin North Am 1982; 13:242-77.
- Steinberg ME. Evolution and development of surface replacement arthroplasty. Orthop Clin NorthAm 1982; 13:661-2.
- Steinberg ME. Summary and conclusions. Orthop Clin North AM 1982; 13:895902.
- Moore AT, Boklman Hr. Metal hip joint, a case report. J Bone Joint Surg 1943; 25:688-92.
- Moore AT. The self-locking metal hip prosthesis. J Bone Joint Surg 1947;39A: 811-27
- Thompson FR. Two and a half years' experience with a vitallium intramedullary hip prosthesis. J Bone Joint Surg 1954. pp.489-502.
- Charnley J. Total hip replacement by low friction arthroplasty. Clin Orthop 1970; 72:7-21.
- Charnley J. Total prosthetic replacement of the hip. Triangle 1968; 8:211
- Charnley J. Sub specialization or supra specialization in surgery? Br Med J 1970; 2:719.
- Thieme Atlas of Anatomy (2006), p 378
- Faller (2004), pp 174-175
- Lequesne, M (2004). "The normal hip joint space: variations in width, shape, and architecture on 223 pelvic radiographs". Annals of the Rheumatic Diseases. 63 (9): 1145-1151
- Platzer 2004, pp. 198
- Platzer 2004, pp. 200
- Thieme Atlas of Anatomy (2006), pp 383, 440
- National Institute for Health and Care Excellence (NICE). Osteoarthritis: Care and management in [Internet] Available from:
http://www.nice.org.uk/guidance/cg177/chapter/introduction - JOTANOVIC Z, MIHELIC R, SESTAN B, DEMBIC Z 2012 Role of interleukin-1 inhibitors in osteoarthritis: an evidence-based review. Drugs Aging 29(5): 343-58ALTMAN R, ALARCON G, APPELROUTH D, BLOCH D, BORENSTEIN D, BRANDT K et al. 1991 The American College of Rheumatology criteria.