Rehabilitation outcomes post cemented and cementless total hip replacements in patients with primary coxarthrosis: Comparative study

Background: Degenerative and deformative changes of the hip joints rank among the most severe and most common musculoskeletal conditions affecting the elderly and reasonable number of these patients receive Total hip replacement (THR) with or without cement. The aim of this study was to assess outcomes of rehabilitation following cemented and cementless THR in patients with primary coxarthrosis, and also to compare the outcomes between the two groups to see if there will be any significant difference in the outcomes measured. Materials and Methods: Twenty (20) patients were purposively recruited to participate in this study from a population of coxarthrosis patients billed to undergo THR. The patients were divided into two groups with 10 participants each to undergo either cemented or cementless THRs. The demographic parameters of all the participants were recorded. All the participants were administered Visual Analogue Scale (VAS), Harris Hip Scores (HHS), Western Ontario and McMaster Osteoarthritis Index (WOMAC) and Total Range of Motion (TROM) of the affected hip joints were measured before surgery and at the 7TH week after the surgery and rehabilitation and all the participants underwent similar rehabilitation post-surgery.
Results: 15 Females (75%) and 5 Males (25%) participated in the study, with the cemented group having 8 Females (80%) and 2 Males (20%), while the cementless group had 7 Females (70%) and 3 Males (30%). The mean ages of the participants were 72.10 and 61.70 years for the cemented and cementless groups respectively. All baseline parameters of the participants (Age, VAS, HHS, WOMAC and TROM) were comparable between the groups (P>0.05). There were significant improvements in post rehabilitation scores for VAS and HHS when compared to pre-THR scores in both groups (P<0.05). The post rehabilitation scores for TROM were significantly higher than the pre THR scores in the cementless group (P<0.05). However, no significant difference was found between the baseline and post rehabilitation WOMAC scores of both groups (P>0.05). Lastly, the results showed that the cementless group had significantly higher value at post rehabilitation for the TROM when compared to the
cemented group (P<0.05).
Conclusions: It was concluded that; Rehabilitation improves the quality of life and pain in patients after Total Hip Replacement (THR) irrespective of the type of prosthesis used (cemented or cementless) and Cementless THR has showed better improvement in hip joint total range of motion after rehabilitation than the cemented THR.

Key Words: Coxarthrosis, Total Hip Replacement, Rehabilitation, Outcomes

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Vincent Pol University in Lublin