Is large femoral head a better option than a conventional femoral head primary total hip arthroplasty in Indian population

Authors

  • Hiranya Kumar Seenappa Department of Orthopaedics, Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bengaluru, Karnataka, India
  • Karthik Mittemari Naraynamurthy Department of Orthopaedics, Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bengaluru, Karnataka, India
  • Rasiq Rashid Department of Orthopaedics, Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bengaluru, Karnataka, India
  • Shivraj Nadagouda Department of Orthopaedics, Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bengaluru, Karnataka, India
  • Vamshhikrishna Chand Department of Orthopaedics, Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bengaluru, Karnataka, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20210622

Keywords:

Total hip arthroplasty, Conventional femoral head, Large femoral head, Modified harris hip score, Range of movement

Abstract

Background: Study aimed to assess and compare the functional outcome in patients underwent the large femoral head THA and conventional femoral head THA.

Methods: It is a comparative prospective cross sectional study conducted among the patients undergoing primary total hip arthroplasty through postero-lateral approach at department of orthopaedics Vydehi institute of medical sciences, Bengaluru during the period of July 2017 to July 2019. Patients aged between 18-80years of both genders undergoing Primary THA for Osteoarthritis (OA), Rheumatoid Arthritis (RA), Ankylosing Spondylitis (AS), Post traumatic arthritis, Avascular necrosis (AVN), Acute fracture neck of femur, Non-union fracture neck of femur (NOF). Patients undergoing primary total hip arthroplasty in Intertrochanteric fracture, Acetabular fracture and patients undergoing Revision Hip Arthroplasty were excluded from study. Patients were grouped as the ones treated with large femoral head THA and conventional femoral head THA.

Results: This series consisted of 36 patients with 44 diseased hips treated with primary total hip arthroplasty (THA). Out of 36 patients, 9 patients (25%) belonged to an age group of below 30 years of age, 10 patients (27.8%) belonged to the age group between 31-40 years of age, 8 patients (22.2%) belonged to the age group 41-51 years of age and 9 patients (25%) belonged to age group of 51-60 years of age. The mean level of Modified Harris Hip score and improvement of movements in all planes was found to be statistically significantly in the patients treated with large femoral head primary THA compared to those treated with conventional method. (p<0.001)

Conclusions: Study has shown improved functional outcome (Modified harris hip score) and range of movement in the patients treated with the large femoral head primary THA as compared to those treated with a conventional femoral head.

Author Biographies

Hiranya Kumar Seenappa, Department of Orthopaedics, Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bengaluru, Karnataka, India

Prof. & H.O.D

Department of Orthopaedics

Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka

Karthik Mittemari Naraynamurthy, Department of Orthopaedics, Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bengaluru, Karnataka, India

Assoc. Professor

Department of Orthopaedics

Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka

Rasiq Rashid, Department of Orthopaedics, Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bengaluru, Karnataka, India

Senior Resident 

Department of Orthopaedics

Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka

Shivraj Nadagouda, Department of Orthopaedics, Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bengaluru, Karnataka, India

Asst. Professor 

Department of Orthopaedics

Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka

References

Gupta DL, Lal DM, Aggarwal DV, Rathor DLP. Assessing functional outcome using modified Harris hip score in patients undergoing total hip replacement. Int J Orthop Sci. 2018;4(2):1015-017.

Karachalios T, Komnos G, Koutalos A. Total hip arthroplasty: Survival and modes of failure. EFORT open Rev. 2018;3(5):232-39.

American Joint Replacement Registry-Annual Report. 2016:16-20.

Norwegian Arthroplasty Register. Acta Orthop Scan. 2003;74(5):514-24.

Zagra L, Gallazzi E. Bearing surfaces in primary total hip arthroplasty. EFORT open Rev. 2018;3(5):217-24.

Triclot P, Gouin F. Update - “Big-head”: The solution to the problem of hip implant dislocation? Orthop Traumatol Surg Res. 2011;97(4):42-48.

Muratoglu O, Bragdon C, O'Connor D, Perinchief R, Estok D, Jasty M, Harris W. Larger diameter femoral heads used in conjunction with a highly cross-linked ultra–high molecular weight polyethylene: A new concept. The Journal of Arthroplasty. 2001;16(8):24-30.

Hammerberg E, Wan Z, Dastane M, Dorr L. Wear and Range of Motion of Different Femoral Head Sizes. The Journal of Arthroplasty. 2001;25(6):839-43.

Mulholland SJ, Wyss UP. Activities of daily living in non Western cultures: Range of motion requirements for hip and knee joint implants. Int J Rehabil Res. 2001;24:191-8.

Cho M, Choi W, Kim J. Current Concepts of Using Large Femoral Heads in Total Hip Arthroplasty. Hip & Pelvis. 2016;28(3):134.

Banerjee S, Pivec R, Issa K, Kapadia B, Kanuja H, Mont M.Large-Diameter Femoral Heads in Total Hip Arthroplasty: An Evidence-Based Review. The American Journal of Orthopaedics. 2014; 43(11):506-12.

Harkess J, Crockarell Jr J. Campbell's Operative Textbook for Orthopaedics. 13th ed. Elsevier. 2017;167-313.

Muratoglu O, Bragdon C, O'Connor D, Perinchief R, Estok D, Jasty M, Harris, W. Larger diameter femoral heads used in conjunction with a highly cross-linked ultra–high molecular weight polyethylene: A new concept. The Journal of Arthroplasty. 2001;16(8):24-30.

Söderman P, Malchau H. Is the Harris hip score system useful to study the outcome of total hip replacement? Clin Orthop Relat Res. 2001;(384):189-197.

Jordan F Schaeffer THM. Effect of Femoral Head Diameter on Risk of Dislocation after Primary Total Hip Arthroplasty. J Arthritis. 2013;02(01):1-4.

Singh SP, Bhalodiya HP. Head size and dislocation rate in primary total hip arthroplasty. Indian J Orthop. 2013;47(5):443-48.

Amstutz HC, Le Duff MJ, Beaule PE. Prevention and treatment of dislocation after total hip replacement using large diameter balls. Clin Orthop Relat Res. 2004;(429):108-16.

Howie D, Holubowycz O, Middleton R. Large Femoral Heads Decrease the Incidence of Dislocation After Total Hip Arthroplasty. The Journal of Bone and Joint Surgery-American Volume. 2012;94(12):1095-1103.

Amlie E, Høvik Ø, Reikerås O. Dislocation after total hip arthroplasty with 28 and 32 mm femoral head. J Orthop Traumatol. 2010;11:111-15.

Magee T, Schaeffer J, Buck D, Gililland J, Hofmann A. Effect of Femoral Head Diameter on Risk of Dislocation after Primary Total Hip arthroplasty. J Arthritis. 2013;2(1):2167-7921.

Kim M, Chung Y, Lee J, Kim C. Measuring the Impact of Femoral Head Size on Dislocation Rates Following Total Hip Arthroplasty. Hip Pelvis. 2017;29(2):91-96.

Lavigne, M., Ganapathi, M., Mottard, S., Girard, J. and Vendittoli, P. Range of motion of large head total hip arthroplasty is greater than 28mm total hip arthroplasty or hip resurfacing. Clinical Biomechanics. 2011;26(3):267-273.

Sultan P, Tan V, Lai M, Garino J. Independent contribution of elevated-rim acetabular liner and femoral head size to the stability of total hip implants. The Journal of Arthroplasty. 2002;17(3):289-92.

Burroughs B, Hallstrom B, Golladay G, Hoeffel D, Harris W. (). Range of Motion and Stability in Total Hip Arthroplasty With 28-, 32-, 38-, and 44-mm Femoral Head Sizes. The Journal of Arthroplasty. 2005;20(1):11-19.

Campbell's Operative Textbook for Orthopaedics. 13th ed. Elsevier. 2017;167-313.

Bartz RL, Noble PC, Kadakia NR, Tullos HS. The effect of femoral component head size on posterior dislocation of the artificial hip joint. J Bone Joint Surg [Am]. 2000;82-A:1300-307.

Hammerberg E, Wan Z, Dastane M, Dorr L. Wear and Range of Motion of Different Femoral Head Sizes. The Journal of Arthroplasty. 2010;25(6):839-43.

Plate JF, Seyler TM, Stroh DA, Issa K, Akbar M, Mont MA. Risk of dislocation using large- vs. small-diameter femoral heads in total hip arthroplasty. BMC Res Notes. 2012;5(1):553-57.

Agarwala S, Mohrir G, Moonot P. Functional outcome following a large head total hip arthroplasty: A retrospective analysis of mid term results. Indian J Orthop. 2014;48(4):410-14.

Downloads

Published

2021-02-23

Issue

Section

Original Research Articles