Short term outcome of primary un-cemented total hip arthroplasty in osteonecrosis of femoral head


  • Mohmad Nawaz Rather Department of Orthopaedics, SKIMS, MC & H Srinagar, India
  • Wajahat Ahmad Mir Department of Orthopaedics, SKIMS, MC & H Srinagar, India
  • Shahid Shabir Khan Department of Orthopaedics, SKIMS, MC & H Srinagar, India
  • Naseer Ahmad Mir Department of Orthopaedics, SKIMS, MC & H Srinagar, India
  • Nadeem Ali Bone and joint hospital, Barzulla, Srinagar, India



Osteonecrosis of femoral head, Total hip arthroplasty, Harris hip score


Background: Osteonecrosis of femoral head (ONFH) is characterised by cell death in the subchondral bone caused by abnormalities of blood flow to the femoral head. About 5% to 13% of arthroplasties are performed yearly for ONFH in United States. Ficat and Arlet classification is the commonest system used for grading of ONFH. Advanced stages 3 and 4 are best managed with total hip arthroplasty (THA). THA restores hip range of movement and allows early ambulation in ONFH.

Methods: After seeking approval from local institutional ethical committee 25 patients with stage 3 and stage 4 ONFH (Ficat and Arlet) were admitted from OPD of SKIMS MC and Hospital Bemina, Srinagar. The study was conducted from February 2018 to February 2020 in department of Orthopaedics SKIMS MC and Hospital Bemina, Srinagar.  25 patients with mean age of 50.64 years comprising of 13 females and 12 males with unilateral osteonecrosis of femoral head with collapsed head underwent uncemented total hip arthroplasty and were followed up to a minimum of 1 year post-operatively.

Results: Outcome was evaluated by comparing pre-operative and post-operative Harris hip scores. The average Harris hip scores improved from 65.87 in the pre-operative group to 96.54 at 1-year follow-up post-operatively. Marked improvement was noted in pain scores. No revisions were performed during the study. One patient developed superficial surgical site infection which healed with supervised dressings and oral antibiotics.

Conclusions: Uncemented THA has excellent short-term outcomes in advanced stages of ONFH. It provides mobile hip joint and pain free ambulation shortly after surgery.

Author Biographies

Mohmad Nawaz Rather, Department of Orthopaedics, SKIMS, MC & H Srinagar, India


Senior resident

Wajahat Ahmad Mir, Department of Orthopaedics, SKIMS, MC & H Srinagar, India

Senior resident


Shahid Shabir Khan, Department of Orthopaedics, SKIMS, MC & H Srinagar, India


Senior resident


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Original Research Articles