الفهرس | Only 14 pages are availabe for public view |
Abstract Modern total hip replacement can improve patient quality of life more than any other elective surgical procedure. Due to the projected 172% increase in demand for THA procedures over the next decade, it is critical that clinicians continue to find ways to improve patients’ experiences. Patient satisfaction is a cornerstone in healthcare that is now being used as a metric in hospital reimbursement. Therefore, we performed this study to assess patient satisfaction in accordance to harris hip score (HHS) after total hip arthroplasty in osteoarthritic patients and in patients with fracture neck of femur. Patients and Methods This study included 33patients in Menoufia University Hospital. Inclusion criteria was elderly patients with BMI less than 40 who suffered from Osteoarthritic joint or Fracture neck of femur. Exclusion criteria were patients with chronic uncontrolled medical disorder, Revision arthroplasty cases, associated knee pathology, associated actubular fracture. Patients’ socio-demographic parameters were reported. General and local examination, radiological investigation, laboratory investigation were performed. Patients was assessed with functional scoring systems (Harris Hip Score). Patient was assessed in every post-operative visit which was scheduled in one week, 2 weeks, 4 weeks, 12 weeks and 6 months. The results could be summarized as follow: The mean age of included patients in osteoarthritis group was 65 years old. 62.5% of patients with fracture in femur neck were female. There were no statistically significant difference between both groups regarding age, gender and comorbidities. 51.51% of included patients suffered from osteoarthritis and 48.48% of included patients suffered from fracture neck of femur. Cup of fixation was cementless in 90.6% of included patients. The type of femur fixation and cup type were cementless in the majority of included patients in both groups. 70.6% osteoarthritis patients underwent THR for right limb. There were no statistically significant difference between both groups regarding side of injury, femur type and cup type. There were a statistically significant difference between both groups in the improvement of ROM. Worsened ROM were observed in the majority of patients with femur neck fracture, while improved ROM were observed in the majority of patients with osteoarthritis. The improvement in HHS score after THR were higher in patients with osteoarthritis than patients had femur neck fracture. The majority of patients with femur neck fracture (68.8%) had poor HHS score after THR, while the majority of patients with osteoarthritis (58.8%) had excellent HHS score after THR. There were a negative correlation between the improvement of HHS grade and type of complain. The presence of femur neck fracture is associated with lower improvement in HHS. Radiological evaluation demonstrated that the majority of included patients in both groups had accepted criteria. While one patients in each group had varus stem and other in each group suffered from retroverted cup. Cement mantle >2mm below stem was observed in one patients with femur neck fracture. |