الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 224 |  |  |
| | | from | 224 | | |
Abstract
Background: In spite of operative difficulties, higher complication rates and less reliable outcomes of THA performed for patients with PTOA in comparison with THA done for those with 1ry OA, THA is still a viable and effective option in treatment of PTOA of the hip. The aim of the work: To compare the results of THA for posttraumatic and primary osteoarthritis of the hip as regard: operative difficulties, clinical and radiological outcomes. Materials and Methods: This prospective study was conducted at Orthopaedic Department, Mansoura University aiming to compare the results in patients who performed THA for posttraumatic OA and a control group with matching age and sex who performed THA for 1ry OA of the hip during the same period. The study was conducted in the period from October 2015 till September 2019.Results: The study included 44 cases (22 cases for each group). group I included patients with post traumatic OA, and group II included cases with primary OA. group I was furtherly subdivided into two subgroups; subgroup IA that included 11 cases with acetabular fractures, and subgroup IB that included 11 cases with proximal femoral fractures. The study was approved by the local ethical committee. All the included cases underwent complete history taking, thorough physical examination, and routine preoperative investigations. Moreover, they were assessed via different hip scores to assess the severity of OA and to evaluate postoperative outcomes. As regard the surgical details, spinal anaesthesia, lateral decubitus and posterior approach were utilized in all patients. Difficult exposure was encountered in nine (40.9%) cases in the PTOA group and additional soft tissue release was needed (p = 0.001). Routinely, cementless implants were used in all patients in both groups except for, six (27.3%) cases in the PTOA group where hybrid implant was utilized (p = 0.008). Operative time was more prolonged in group I (126.1 vs. 86.4 min – p < 0.001). Furthermore, Blood loss, transfusion requirements, and length of hospital stay were higher in group I. As regard the clinical evaluation, there was statistically significant improvement in PROMs and global ROM at the end of follow up in contrast to the preoperative state in both groups with more improvement in group I regarding PROMs and in group II concerning global ROM. Radiological evaluation did not detect any significant findings between the two groups as well. On comparing subgroup IA and subgroup IB, no statistically significant differences were noticed between the 2 subgroups regarding surgical difficulties, postoperative clinical or radiological evaluation except for operative time that was significantly longer in subgroup IA and acetabular abduction angle which increased significantly in subgroup IA than in subgroup IB. Conclusion: Coming to a conclusion, the present study delineates that THA for PTOA following prior acetabular or proximal femoral fractures after is often more complex than the routine THA as a result of extensive scarring, HO, retained hardware, residual deformity and bone deficiency of both the acetabulum and the femur. In spite of these difficulties, the clinical outcomes were reasonable in most patients and the rate of complications was acceptable far more away than expected with a high level of patients’ satisfaction. Hence, our goals in reduction of pain and restoration of ambulation while avoiding complications in this group of population were all met through this study series.