TOTAL HIP ARTHROPLASTY IN AVASCULAR NECROSIS OF THE HIP: A PROSPECTIVE OBSERVATIONAL STUDY ON FUNCTIONAL AND RADIOLOGICAL OUTCOMES
Bibliographic record
Abstract
Background: Avascular necrosis (AVN) of the femoral head is a debilitating condition that leads to progressive joint destruction and functional impairment. Total Hip Replacement (THR) remains the definitive treatment for advanced-stage AVN (Ficat-Arlet III/IV), yet variations in outcomes based on patient demographics, aetiology, and surgical approaches necessitate further investigation. This study evaluates the functional and radiological outcomes of THR in AVN patients over a 26-month duration. Methods: A prospective observational study was conducted on 50 patients diagnosed with AVN of the hip who underwent THR. Patients were assessed preoperatively and postoperatively at 6 weeks, 3 months, 6 months, and 1 year using Harris Hip Score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Visual Analog Scale (VAS) for pain relief. Radiological outcomes, surgical approaches (Southern Moore vs. Hardinge), complications, and range of motion (ROM) improvements were analysed. Statistical significance was determined using paired t-tests, ANOVA, and Kaplan-Meier survival analysis. Results: Significant functional improvement was observed with HHS increasing by 116.2% at 12 months (p < 0.001) and VAS scores improving by 77.8% (p < 0.001). Post-traumatic AVN patients exhibited superior outcomes (HHS: 92.1) compared to steroid-induced cases (HHS: 89.2). Radiological evaluation confirmed satisfactory implant positioning in all cases, with 92% showing optimal osseointegration and mild radiolucency (<2 mm) in 8%. ROM improved significantly, with internal rotation (+137.5%) and adduction (+111.3%) showing the highest gains. The Southern Moore approach was associated with 2 cases (4%) of neurapraxia (foot drop), while the Hardinge approach had no neurovascular complications. No cases of periprosthetic fractures, deep vein thrombosis (DVT), or implant loosening were recorded. Conclusions: THR in AVN patients significantly improves function, reduces pain, and restores mobility, with better outcomes in younger patients (<40 years) and post-traumatic AVN cases. The study reinforces the efficacy of fenestrated cemented femoral stems in promoting osseointegration. The Southern Moore approach carries a higher risk of nerve injury, necessitating careful patient selection. Further long-term studies are required to assess implant longevity and the impact of surgical techniques on long-term outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".