Effectiveness of Total Hip Replacement in Young Patients with Avascular Necrosis of the Femoral Head

Keywords. Avascular necrosis, hip replacement, orthopaedics. Objectives. To evaluate the feasibility of total hip replacement (THR) in young patients aged 20 to 55 with avascular necrosis of the femoral head, to compare preoperative and postoperative findings, based on the Harris hip score (HHS), to find if there is a statistically significant correlation between the Kerboul angle and preoperative HHS results, and the stage of AVN. Materials and Methods. Forty-nine patients participated in the study. Each patient was evaluated by the Harris hip score (HHS) preoperatively and postoperatively. Preoperative radiographic findings (AP and LL projections) were used to diagnose the stage of AVN and to measure the Kerboul angle, which is used as a prognostic indicator of the femoral head collapse. Results. According to the Harris hip score, there was a 101,36% improvement in all patients on average after total hip replacement. The Kerboul angle was > 200 degrees in forty-eight out of forty-nine patients. There was no statistically significant difference between the Kerboul angle and preoperative HHS results (p=0,229). There was no statistically significant difference between the Kerboul angle and the stage of AVN (p=0,719). Conclusions. Treatment varies considerably, depending on the location and severity of AVN, but the goal of initial treatment is to prevent a collapse of the joint surface. One of the treatment methods is total hip replacement. All patients had a 101,36% improvement according to the postoperative HHS results compared to preoperative ones. All patients benefited from THR. In forty-eight patients, the Kerboul angle was more than 200 degrees, which indicates the high probability of the femoral head collapse. There was a tendency found showing higher HHS results correlated with lower values of the Kerboul angle, although it was statistically insignificant (p=0,229).