Vol. 2, Issue 4, Part A (2018)

Introduction and Background: Many patients with advanced hip joint pathology, such as osteoarthritis, avascular necrosis, or hip fractures, choose for total hip replacement (THR) surgery. Concerns about instability, neurovascular damage, and implant malpositioning persist despite the procedure's success. Patients undergoing THR will be the focus of this investigation of the effects of a thorough anatomical approach on surgical precision, postoperative problems, and functional recovery.

Materials and Methods: Participants were 120 individuals who underwent primary total heart replacement (THR) between July 2017 and June 2018 at the department of General Surgery, I- Care Institute of Medical Sciences and Research, Haldia, West Bengal, India. There were two groups of patients given random assignments: one group (n=60) underwent the procedure using a conventional anatomical approach, and the other group (n=60) underwent the procedure with a comprehensive pelvic anatomical evaluation, which included preoperative CT-based planning and intraoperative navigation. Patients meeting the inclusion criteria had to have femoral head avascular necrosis or end-stage hip osteoarthritis in order to undergo THR.

Results: A considerably reduced frequency of acetabular cup malpositioning (4.5% vs. 15% in Group A, p<0.01) and leg length disparity larger than 5mm (3.3% vs. 13.3%, p=0.02) was observed in patients in Group B, where full pelvic anatomical examination was carried out.** Group B had 1.7% of cases with neurovascular problems, but Group A had 8.3% (p=0.04). These issues included irritation of the sciatic nerve and injury to the superior gluteal artery. Group A had lower WOMAC pain scores at 6 months postoperatively and higher postoperative functional scores, with an average HHS score of 88.5 ± 6.2 compared to 81.3 ± 7.1 in Group B (p=0.001).

Conclusion: Accurate acetabular cup placement, decreased risk of neurovascular problems, and improved functional recovery after total hip replacement are all outcomes of thorough preoperative and intraoperative pelvic anatomy education. In order to maximize surgical success and long-term patient mobility, these data highlight the importance of improved anatomical training and preoperative planning in hip arthroplasty.