A retrospective study to compare the efficacy and postoperative outcome of total hip arthroplasty with internal screw fixation in patients with avascular necrosis of the femoral head

Abstract

Background: This retrospective study compared the effects of total hip arthroplasty (THA) and traditional surgery using internal screw fixation for the treatment of avascular necrosis (AVN) of the femoral head. Material/Methods: Two hundred and seventy patients with bilateral AVN of the femoral head were admitted for elective surgery,and 176 patients underwent THA (the THA group), and 94 patients underwent closed reduction screw fixation (the traditional surgery group). The Harris hip score (HHS) was used pre-operatively and to evaluate postoperative outcome. Results: The mean operation time in the traditional surgery group (82.6±15.6 min) was significantly less compared with the THA group (104.8±14.2 min) (P=0.001). Intraoperative blood loss in the traditional surgery group (219.8±21.6 mL) was significantly less compared with the THA group (339.4±29.4 mL) (P=0.001). After treatment,the mean HHS score of the THA group (76.5±9.2 points) was significantly increased when compared with the traditional surgery group (61.4±10.5 points) (P=0.001). Disease recurrence rate in the THA group was significantly reduced compared with the traditional surgery group (P=0.001). The mean quality of life score of the THA group (85.5±6.4 points) was significantly higher than that of the traditional surgery group (73.4±8.8 points) (P=0.001). Conclusions: Compared with closed reduction screw fixation, THA for AVN of the femoral head effectively reduced the length of hospital stay, time to recovery, and achieved an improved clinical outcome.