Primary Total Hip Replacement in A Military Hospital in Kathmandu

Authors

  • Pankaj Chand Associate Professor, NAIHS
  • Sushil Rana Magar
  • Bishnu Babu Thapa
  • Bikal Shrestha

DOI:

https://doi.org/10.31729/jnma.3033

Abstract

Introduction: Total hip replacement is one of the most widely performed and amongst the most successful orthopedic procedures performed worldwide. Even though it is a common orthopedic procedure in developed nations, it is performed only in selected centers in Nepal.  This study will review the functional outcome of total hip replacements carried out in Shree Birendra Hospital.

Methods: We reviewed the records of total hip replacements, which were carried out in Shree Birendra Hospital, Kathmandu. Twenty-one hips were cemented and nineteen were uncemented.  Cases were followed up in six weeks, twelve weeks, six months and every year from then on. Outcome in terms of Harris hip score of 40 osteoarthritic hips were measured pre-operatively as well as post-operatively.

Results: The mean age of the patients was 50.63 years (range 22-79 years). The commonest reason for the replacement was primary osteoarthritis of the hip. Thirty-nine patients underwent unilateral total hip replacement while in one patient both hips were replaced. The mean Harris hip score for the forty hips that were available at the latest follow-up examination at an average of five years (range two to six and a half years) after the operation was 85.2 ± 7.65 points as compared to the pre-operative mean Harris hip score of 32.38 ± 3.4.

Conclusions: Based on improved Harris hip scores, we believe that THR is a good option in patients with end stage arthritis of the hip.

Keywords: cemented; primary osteoarthritis; total hip replacement.

References

1. Liang M, Cullen K, Larson M, Thompson M, Schwartz J, Fossel A. Cost effectiveness of total joint arthroplasty in osteoarthritis. Arthritis Rheum.1986;29:937–43. [PubMed]
2. Jonsson B, Larsson S. Functional improvements and costs of hip and knee arthroplasty in destructive rheumatoid arthritis. Scand J Rheumatol. 1991;20:351–7. [PubMed]
3. Rissanen P, Aro S, Slatis P, Sintonen H, Paavolainen P. Health and quality of life before and after hip or knee arthroplasty. J Arthroplasty. 1995 Apr;10(2):169-75. [PubMed]
4. Wiklund I, Romanus B. A comparison of quality of life before and after arthroplasty in patients who had arthrosis of the hip joint. J Bone Joint Surg Am. 1991 Jun;73(5):765-9. [PubMed]
5. Laupacis A, Bourne R, Rorrabeck C, Feeny D, Wong C, Tugwell P, et al. The effect of elective total hip replacement on health related quality of life. J Bone Joint Surg Am. 1993 Nov;75(11):1619-26. [PubMed]
6. NB KC, S Rai, P Chand, A Joshi, BR Kunwar. Combined spinal epidural anesthesia for total hip replacement surgery in Birendra Army Hospital. Medical Journal of Shree Birendra Hospital. 2011;10(2):32-6. [Full Text]
7. Callaghan JJ, Bracha P, Liu SS, Piyaworakhun S, Goetz DD, Johnston RC. Survivorship of a Charnley total hip arthroplasty: a concise follow-up, at a minimum of thirty-five years, of previous reports. J Bone Joint Surg Am. 2009 Nov;91(11):2617-21. [PubMed]
8. Yamasaki T, Yasunaga Y, Mori R, Hamanishi M, Shoji T, Ochi M. The Cementless Spotorno stem in THA: 10 year results. Hip Int. 2014 Mar 12;24(1):98-102. [PubMed]
9. Stefl MD, Callaghan JJ, Liu SS, Pedersen DR, Goetz DD, Johnston RC. Primary cementless acetabular fixation at a minimum of twenty years of follow-up: a concise update of a previous report. J Bone Joint Surg Am. 2012 Feb 01;94(3):234-9. [PubMed]
10. Dumbleton J, Manley MT. Hydroxyapatite-coated prostheses in total hip and knee arthroplasty. J Bone Joint Surg Am. 2004 Nov 01;86(11):2526-40. [PubMed]
11. Parry M, Wylde V, Blom AW. Ninety-day mortality after elective total hip replacement: 1549 patients using aspirin as a thromboprophylactic agent. J Bone Joint Surg [Br]. 2008;90-B:306-7. [PubMed]
12. Schousboe JT, Brown GA. Cost-effectiveness of low-molecular-weight heparin compared with aspirin for prophylaxis against venous thromboembolism after total joint arthroplasty. J Bone Joint Surg Am. 2013 Jul 17;95(14):1256-64. [PubMed]
13. Lieberman JR, Pensak JM. Prevention of venous thromboembolic disease after total hip and knee arthroplasty. J Bone Joint Surg Am. 2013;95:1801-11. [PubMed]
14. Fitzgerald RH Jr, Spiro TE, Trowbridge AA, Gardiner GA Jr, Whitsett TL, O'Connell MB et al. Prevention of venous thromboembolic disease following primary total knee arthroplasty. J Bone Joint Surg Am. 2001 Jun;83-A(6):900-6. [PubMed]
15. Jain V, Dhal AK, Dhaon BK, Pradhan G. Deep vein thrombosis after total hip arthroplasty in Indian patients with and without Enoxaparin. J Orthop Surg (Hong Kong). 2004 Dec;12(2):173-7. [PubMed]
16. Hourlier H, Fennema P. Single tranexamic acid dose to reduce perioperative morbidity in primary total hip replacement: a randomised clinical trial. Hip Int. 2014;24(1):63–8. [PubMed]
17. Konig G1, Hamlin BR, Waters JH. Topical tranexamic acid reduces blood loss and transfusion rates in total hip and total knee arthroplasty. J Arthroplasty. 2013 Oct;28(9):1473-6. [PubMed]
18. Bisschop R, Boomsma MF, Van Raay JJ, Tiebosch AT, Maas M, Gerritsma CL. High prevalence of pseudotumors in patients with a Birmingham hip resurfacing prosthesis: a prospective cohort study of one hundred and twenty-nine patients. J Bone Joint Surg Am. 2013 Sep 04;95(17):1554-60. [PubMed]
19. Grammatopoulos G, Pandit H, Kwon YM, Gundle R, McLardy-Smith P, Beard DJ, et al. Hip resurfacings revised for inflammatory pseudotumour have a poor outcome. J Bone Joint Surg Br. 2009 Aug;91(8):1019-24. [PubMed]
20. “Asymptomatic” Pseudotumours after metal-on-metal hip resurfacing arthroplasty: prevalence and metal ion study. J Bone Joint Surg Br. 2011;93-B(SUPP I):66-7. [Full Text]
21. Amstutz HC, Le Duff MJ, Campbell PA, Gruen TA, Wisk LE. Clinical and radiographic results of metal-on-metal hip resurfacing with a minimum ten-year follow-up. J Bone Joint Surg Am. 2010 Nov 17;92(16):2663-71. [PubMed]
22. Girard J, Bocquet D, Autissier G, Fouilleron N, Fron D, Migaud H. Metal-on-metal hip arthroplasty in patients thirty years of age or younger. J Bone Joint Surg Am. 2010 Oct 20;92(14):2419-26. [PubMed]
23.Brun OCL, Maansson L. Fractures of the greater trochanter following total hip replacement. Hip Int. 2013;23(2):143–6. [Full Text]
24. Soong M, Rubash HE, Macaulay W. Dislocation after total hip arthroplasty. J Am Acad Orthop Surg. 2004;12(5):314-21. [PubMed]
25. Goetz DD, Bremner BR, Callaghan JJ, Capello WN, Johnston RC. Salvage of a recurrently dislocating total hip prosthesis with use of a constrained acetabular component: a concise follow-up of a previous report. J Bone Joint Surg Am. 2004 Nov 01;86(11):2419-24. [PubMed]
26. Haddad FS, Muirhead-Allwood SK, Manktelow ARJ, Bacarese-Hamilto. Two-stage uncemented revision hip arthroplasty for infection. J Bone Joint Surg [Br]. 2000;82-B:689-94. [Full Text]
27. Ververeli PA, Lebby EB, Tyler C, Fouad C. Evaluation of reducing postoperative hip precautions in total hip replacement: a randomized prospective study. Orthopedics. 2009 Dec;32(12):889. [PubMed]
28. Bourne RB, Rorabeck CH, Skutek M, Mikkelsen S, Winemaker M, Robertson D. Replacement fixed with so-called second-generation cementing techniques. A ten to fifteen-year follow-up. The Harris Design-2 Total Hip J Bone Joint Surg Am. 1998 Dec; 80(12):1775 -80. [PubMed]

Downloads

Published

2017-03-31

How to Cite

Chand, P., Rana Magar, S., Thapa, B. B., & Shrestha, B. (2017). Primary Total Hip Replacement in A Military Hospital in Kathmandu. Journal of Nepal Medical Association, 56(205), 158–162. https://doi.org/10.31729/jnma.3033

Issue

Vol. 56 No. 205 (2017)

Section

Original Article

License

JNMA allow to read, download, copy, distribute, print, search, or link to the full texts of its articles and allow readers to use them for any other lawful purpose. The author(s) are allowed to retain publishing rights without restrictions. The JNMA work is licensed under a Creative Commons Attribution 4.0 International License. More about Copyright Policy.