Online ISSN: 2515-8260

Keywords : Avascular necrosis

Short Term Outcome of Large Diameter Head In Uncemented Total Hip Arthroplasty 10 Years Outcome Evaluation

Jagannath Desai, Manjunath N, Nagadurga Prasanna Reddy N

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2521-2529

Background: The normal mechanical function of the hip is substantially altered by a variety of disorders. The surgical treatment of such conditions, particularly by hip replacement offers an opportunity not only to replace the articular surface of joint, but also to improve the long term mechanical function by decreasing the load on the joint. Objective: To evaluate short term outcome of large diameter head in uncemented total hip arthroplasty.
Materials and Methods: This study was done in the outpatien and emergency Department of Orthopaedics, Pt. B.D.S.  P.G.I.M.S. Rohtak.  Duration of study period was from January 2010 to June 2020.
Results: 14 cases (58.33%) had avascular necrosis of head of femur, 5 cases (20.83%) had osteoarthritis, one patient had rheumatoid arthritis. 15 patients (60%) were operated on left side, while 8 (32%) were operated on right side and 1 (8%) case was operated on both sides. Metal-on-metal THR was done in 8 cases (32%), Metal-on-polyethylene THR was done in 17 cases (68%) and Ceramic-on-ceramic was done in none. Postoperative pain was absent in 15 patients (60%), mild pain was seen in 9 patients (36%) and moderate pain in one patient (4%).
Conclusion: Total hip arthroplasty continues to be an ideal procedure for achieving painless, mobile, stable hip in cases with advanced hip disorders.

Age and Stage as Crucial Determinant in the Treatment Strategies of Avascular Necrosis of Femoral Head

Dr. Dev Reshi Kumar Pandey Dr. Ripudaman Sharma Dr. Suhail Wani

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 9342-9347

Background: Avascular necrosis of femoral head is an illness characterized by interruption of blood supply to the femoral head and mostly affects young adults. If it is not treated timely, its progression leads femoral head collapse and hip arthroplasty. Along with the idiopathic cases, some predisposing risk factors are also associated to develop avascular necrosis.  Early diagnosis can preserve the hip joint. MRI imaging is considered the most effective and sensitive diagnostic tool for avascular necrosis which is helpful to detect in early stage.
Aim: The purpose of the study was to determine the stages presentation at the time of diagnosis and involved risk factors in etiology of Avascular Necrosis (AVN) of the femoral head.
Material & Method: This study conducted in orthopaedic department at GS Medical College. 50 patients of all age groups diagnosed with avascular necrosis after MRI of hip joint were included in this study. Patient information regarding age, sex, causative factors was collected from patient chart. Staging of disease was done according to Ficat and Arlet classification.
Result: It was found that most commonly males of young age group were affected. 76% cases had bilateral involvement of hip joint and 24% patients had unilateral involvement of irrespective site of hip joint. 70% patients presented with stage-III & IV at the tiem of diagnosis of disease. This study also revealed that main risk factor was idiopathic (68%).
Conclusion: Early diagnosis and treatment is the key to prevent progression of disease and can preserve hip joints. MRI evaluation and study of ethology factors can be beneficial in the management of vascular necrosis of femoral head

Fear of avascular necrosis in COVID survivors is real: A rare case series

Dr. Arjun A, Dr. Gopi HG, Dr. Kiran V, Dr. Chaithra CM, Dr. Nagesh Sherikar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1249-1252

COVID-19’ can affect different body systems. At present, osteo necrosis of femoral head as a sequalae of ’COVID-19’ is rarely documented. By large-scale use of life-saving corticosteroids in COVID-19 cases, we anticipate that there will be a resurgence of AVN cases. We report a series of two cases in which patients developed AVN of the femoral head after being treated for COVID-19 infection. The mean dose of corticosteroid used in these cases was 600 mg (400–1250mg), which is less than the mean cumulative dose of around 2000 mg steroid, documented in the literature as causative for AVN. Patients were symptomatic and developed early AVN of bilateral hip at a mean of 42 days after COVID-19 diagnosis as compared with the literature which shows that it generally takes 6 months to 1 year to develop AVN post steroid exposure. Both the patient had significant dysfunction of coagulation with altered parameters. Thorough ophthalmic examination was done to both. literature has showed micro thrombi in eye, heart, liver, kidney, etc. Is corticosteroid being just a confounding factor??

A study for characterization of MRI findings in patients with nontraumatic hip pain

Dr. Poonam Ohri, Dr. Jaspal Singh, Dr. Gagandeep Sharma, Dr. Manasi Kohli

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 4837-4849

Introduction: A study for characterization of MRI findings in patients with nontraumatic
hip pain.
Aims and objectives: To characterize the MRI findings of underlying pathologies in
patients with non-traumatic hip pain and give radiological diagnosis which will help in
the management of patients.
Materials and methods: 50 cases referred to the Department of Radiodiagnosis and
Imaging, Government Medical College, Amritsar with hip pain were evaluated and
statistically analyzed.
Results: Out of the 50 patients, pathology was seen in 45 patients (90%) and while 5
patients (10%) were found to be normal on MRI. The most common pathology detected
was avascular necrosis seen in 23 patients (46%), followed by 12 patients of infective
arthritis patients (24%), 3 patients of perthes disease (6%), 2 patients of bone tumor
(metastasis) (4%), 2 patients of osteitis condensans illi (4%), 2 patients of stress fracture
(4%) and 1 patient of tendinitis 1 (2%).
Conclusions: MRI was helpful in diagnosing various abnormalities. Various bone signal
abnormalities as well as excellent soft tissue contrast aided in making timely diagnosis
and management. The role of MRI in detection of various abnormalities was also
statistically significant (as compared to plain radiographs which was additionally done)
and had more sensitivity and specificity.