Kumar Prasoon, Sen Ramesh K, Aggarwal Sameer, Jindal Karan
Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India.
Department of Orthopaedics, MAX Hospital, Mohali, Punjab, India.
J Clin Orthop Trauma. 2020 Mar;11(Suppl 2):S192-S195. doi: 10.1016/j.jcot.2019.02.009. Epub 2019 Feb 10.
Primary osteoarthritis of hip has been widely reported to be the leading cause for total hip replacement (THR) in the world. The other common causes are avascular necrosis of hip, inflammatory diseases and trauma sequelae. We report the prevalence of these disease as studied retrospectively at a tertiary healthcare centre and discuss the common age groups and sex ratios of these patients as compared to the West. Additionally, we compare the outcomes of these surgeries based on the aetiologies for which they were done.
Patients who underwent primary THR in our institute within six years were called and retrospectively analysed. Revision cases were excluded. All the surgeries were done by a single experienced arthroplasty surgeon. On follow ups, functional scores were assessed using standard Harris hip score (HHS) and quality of life scores were assessed using the Short musculoskeletal functional assessment (SMFA) score.
118 hips in 99 patients (M:F- 3.2:1) with a mean age group of 43.22 years, were operated over a period of six years. Non traumatic avascular necrosis (AVN) of hip topped the list in our study with 42.4% of cases, followed by post-traumatic sequelae (30.5%). These were followed subsequently by primary osteoarthritis (OA) (14.4%) and the remaining were inflammatory pathologies (IA). The HHS of patients with non traumatic AVN hip, traumatic sequelae and primary osteoarthritis were significantly superior to inflammatory arthritis with a p value of 0.001, 0.001 and 0.016 respectively. Additionally the short musculoskeletal functional assessment score was also significantly higher in IA than AVN, OA and post trauma groups (p = 0.001, 0.037 and 0.002 respectively); where a higher score denotes inferior outcomes.
In our part of the world, non traumatic AVN hip is the commonest indication for primary hip arthroplasty, followed by traumatic sequelae. The frequency of males undergoing hip arthroplasty is much more than females and at a younger age as compared to the West. Additionally, the functional outcomes in cases of inflammatory arthritis are inferior as compared to the other indications, probably because of associated contractures, deformity and spinal issues.
髋关节原发性骨关节炎已被广泛报道为全球全髋关节置换术（THR）的主要原因。其他常见原因包括髋关节缺血性坏死、炎症性疾病和创伤后遗症。我们报告了在一家三级医疗中心进行回顾性研究的这些疾病的患病率，并讨论了与西方相比这些患者的常见年龄组和性别比例。此外，我们根据手术病因比较了这些手术的结果。
对在我院6年内接受初次THR的患者进行电话随访并进行回顾性分析。排除翻修病例。所有手术均由一位经验丰富的关节置换外科医生完成。在随访中，使用标准的Harris髋关节评分（HHS）评估功能评分，并使用简短肌肉骨骼功能评估（SMFA）评分评估生活质量评分。
99例患者（男∶女 = 3.2∶1）的118个髋关节在6年期间接受了手术，平均年龄为43.22岁。在我们的研究中，非创伤性髋关节缺血性坏死（AVN）位居榜首，占病例的42.4%，其次是创伤后遗症（30.5%）。随后是原发性骨关节炎（OA）（14.4%），其余为炎症性病变（IA）。非创伤性AVN髋关节、创伤后遗症和原发性骨关节炎患者的HHS明显优于炎症性关节炎患者，p值分别为0.001、0.001和0.016。此外，IA组的简短肌肉骨骼功能评估评分也明显高于AVN、OA和创伤后组（p分别为0.001、0.037和0.002）；评分越高表示结果越差。
在我们所在的地区，非创伤性AVN髋关节是初次髋关节置换术最常见的指征，其次是创伤后遗症。与西方相比，接受髋关节置换术的男性频率远高于女性，且年龄更小。此外，与其他指征相比，炎症性关节炎病例的功能结果较差，可能是由于相关的挛缩、畸形和脊柱问题。
