Primary cemented total hip arthroplasty: 10 years follow-up.

Abstract

Primary cemented total hip arthroplasty is a procedure for non-traumatic and traumatic affections of the hip. Long term follow-up is required to assess the longevity of the implant and establish the procedure. Indo-Asian literature on long term result of total hip arthroplasty is sparse. We present a 10-year follow-up of our patients of primary cemented total hip arthroplasty. We operated 31 hips in 30 patients with primary cemented total hip arthroplasty. We followed the cases for a minimum period of 10 years with a mean follow-up period of 12.7 years. The mean age of the patients was 60.7 years (range 37-82 yrs) male to female ratio was 2:1. The clinical diagnoses included - avascular necrosis of femoral head (n=15), sero positive rheumatoid arthritis (n=5), seronegative spondylo-arthropathy (n=4), neglected femoral neck fractures (n=3), healed tubercular arthritis (n=2) and post traumatic osteoarthritis of hip (n=2). The prostheses used were cemented Charnley's total hip (n=12) and cemented modular prosthesis (n=19). The results were assessed according to Harris hip score and radiographs taken at yearly intervals. The mean follow-up is 12.7 yrs (range 11-16 yrs) Results in all operated patients showed marked improvement in Harris hip score from preoperative mean 29.2 to 79.9 at 10 years or more followup. However, the non-inflammatory group showed more sustained long term improvement as compared to the inflammatory group, as revealed by the Harris hip score. Mean blood loss was 450ml (+/-3.7 ml), mean transfusion rate was 1.2 units (+/-.3). The complications were hypotension (n=7), shortening >1.5 cm (n=9), superficial infection (n=2) and malposition of prosthesis (n=1). The needs of Indian Asian patients, vary from what is discussed in literature. The pain tolerance is greater than western population and financial constraints are high. Thus revision surgery among Indian-Asian patients is less compared to western yard sticks.