Outcome of Total Hip Replacement Surgery Ankylosed Hip in Young Patient: Tertiary Level Hospital in Rajshahi

Background: Total Hip replacement is the standard therapy for hip ankylosis, which produces reduced hip mobility. This research aimed to use the Harris Hip Score (HHS) to analyze clinical findings and results of treatments for hip ankylosis. Methods: A multicentered-based, non-randomized quasiexperimental prospective study was performed in Rajshahi Medical College Hospital, Dhaka Medical College Hospital, Rajshahi, from January 2018 to December 2022.A total number of patients (N=77) with ankylosis in one or both hip joints, Electromyogram, and nerve conduction studies were taken from the hip abductor muscles before surgery, and HHS was calculated. Type of surgery and prosthesis, osteotomy required for the neck and trochanteric region of the femur, periprosthetic fracture, and the need to restore the acetabulum were studied in the patients. Postoperative complications such as infection and dislocation at 3, 6, and 12 months after surgery were examined, and then the HHS was calculated. Results: At the end of 04 years after surgery, the functional results were analyzed by SPSS 23.0. Seventy-seven patients (42 m/35 f) with a mean age of 36.71±11.78 years underwent total hip arthroplasty. Hip joint ankylosis was most commonly brought on by osteoarthritis of old age (20 cases) and avascular necrosis (13 cases). Twelve individuals had high conduction on electromyograms, while 65 patients had low conduction on nerve conduction examinations. We used the posterior approach in 55 patients (71.4%) and the lateral approach in 22 patients (28.6%). The periprosthetic fracture occurred in two patients, and 12 patients needed acetabular reconstruction. The standard prosthesis was used in 83.1% of patients. Nine patients were excluded after six months, and two patients were excluded after 12 months due to surgery complications. At the early stage, patients' HHS averaged 48.53±6.28; after 12 months, it had improved to 88.22±3.78 (P<0.001). Conclusions: Patients with ankylosed hips may benefit from total hip replacement, particularly in long-term follow-up. The absence of pre-and postoperative complications is necessary for evaluating successful outcomes.