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Abstract In the twenty-first century, osteoarthritis (OA) is the most common joint disorder in the adult population. This degenerative disease mostly affects weight bearing joints and the number of cases of symptomatic OA is likely to increase worldwide due to the aging of the population and the resultant restriction of functional status due to pain in OA, patients are vulnerable to gain weight adding more risk for OA progression. It has been shown that total hip replacement (THR) provides excellent pain relief and improved quality of life for patients with painful arthritis of the hip. Total hip arthroplasty (THR) is one of the most successful procedures performed in modern orthopaedics. One consequence of these impressive results is that the prevalence of THR continues to rise. A recent study estimates that the demand for THR will increase by over 150% during the next 2 decades due in large part to the steadily growing elderly population. The development of an operative treatment that both relieves pain on the short term and restores motion with better functional performance in the long-term has therefor been of paramount importance to many patients suffering from osteoarthritis, rheumatoid arthritis, and arthritis secondary to other causes THR has therefore been referred to as ”the operation of the century” Acetabular fractures are serious injuries which can lead to progressive impairment of hip function. Unfortunately, many patients with fractures of the acetabulum still suffer post-traumatic arthritis. Even when near-anatomic reductions are achieved, the reported incidence of post-traumatic arthritis has been varied between 27 and 37 %, with the incidence of subsequent total hip arthroplasty (THA) ranging from 8 to 23%. Summary 109 The aim of this work is to plan and manage difficult acetabulum component in total hip arthroplasty and to evaluate the clinical and radiological outcomes of these patients. This prospective cross-sectional study was conducted in orthopedic surgery department at Menofia University hospital and Kafr Eldawar general hospital. This study was conducted on 21 patients underwent total hip replacement. The main results of the study revealed that: MHHS of the studied group. There was a highly statistically significant difference between Preoperative and Postoperative (p<0.001). At preoperative time it was ranged between 0 – 57 with a mean value of 23.95±15.263 and it was increased significantly to be at postoperative time with a mean value of 79.05±12.167 showing that postoperative results were better. Days of hospitalization was ranged between 2 – 5 days with a mean value of 2.95±0.921 days. Return to activity was ranged between 2 – 5 months with a mean value of 3.38±0.865 months. Complications of the studied group and it show that 1(4.8%) had Leg length discrepancy, 3(14.28%) had Sciatic pain, 1(4.8%) had DVT and 1(4.8%) had Trochanteric bursitis. Statistically significant differences between non satisfaction patients and satisfaction patients according to age (P=0.047) and smoking status (P=0.025). There was a statistically significant difference between non satisfaction patients and satisfaction patients regarding smoking showing higher satisfaction in the not smoking group and younger patients. Summary 110 There was a statistically highly significant difference between unsatisfactory and satisfactory patients regarding IIb classification (p=0.01) showing lower satisfaction. Statistically high significant difference between non satisfaction patients and satisfaction patients where (P=0.00001) showing higher satisfaction in the primary group. Relation between patient’s satisfactions and graft and it shows no statistically significant differences between non satisfaction patients and satisfaction patients. There was a statistically significant difference between totally cementless, totally cemented and cemented cup on cementless stem in satisfactory patients (p<0.001) as well as unsatisfactory patients (p<0.005) showing higher satisfaction in totally cementless and then totally cemented. Statistically significant differences between non satisfaction patients and satisfaction patients where P=0.025 and 0.012 respectively showing less days of hospitalization in satisfactory patients. Satisfactory patients showed less period to return to activity. No statistically significant differences between Leg length discrepancy, sciatic pain, trochanteric bursitisand DVT in satisfactory and non-satisfactory patients. Based on our results we recommend for further studies on larger patients and longer period of follow up to emphasize our conclusion. |