Efficacy analysis of total hip arthroplasty in patients with non-traumatic osteonecrosis of the femoral head based on diverse medical needs
CHEN Qi
ZHANG Kun
LU Chao
HAO Yang-quan
Abstract：Objective To compare the short-term efficacy of total hip arthroplasty(THA)in patients with non-traumatic osteonecrosis of the femoral head(NONFH)based on pain or limited mobility as the primary medical need.Methods This study was a retrospective cohort study that included 101 patients with end-stage femoral head osteonecrosis who underwent unilateral THA for the first time at Honghui Hospital Affiliated to Xi'an Jiaotong University from June 2022 to June 2023.Based on the medical needs for selecting THA,patients were divided into a pain group comprising 63 cases,with 35 males and 28 females and a mean age of(51.75±13.11)years.The limited mobility group(hereinafter referred to as the functional limitation group)consisted of 38 cases,including 23 males and 15 females,with a mean age of(48.61±14.57)years.The disease progression period was calculated from the initial diagnosis of femoral head osteonecrosis to THA surgery,and patient outcomes were evaluated using pre-operative and final follow-up assessments,including the Harris Hip Score(HHS)and Numerical Rating Scale(NRS)for pain.Results All 101 patients were followed up postoperatively,with a follow-up duration ranging from 6 to 18 months and a mean of(11.91±0.31)months;no statistically significant differences were observed in baseline characteristics between the two groups(P>0.05).Preoperatively,there was no statistically significant difference in HHS between the two groups(P>0.05);The NRS score was(7.14±1.13)in the pain group and(6.47±1.64)in the functional limitation group,demonstrating a statistically significant difference between the groups(P<0.05);The activity level score was(0.95±0.90)in the pain group and(0.52±0.82)in the functional limitation group,indicating a statistically significant difference between the groups(P<0.05).At the final postoperative follow-up,no statistically significant differences were found in HHS,NRS scores,or activity levels between the two groups(P>0.05).In the comparison of score differences between pre-operative and final follow-up,the NRS score difference was(6.59±1.41)in the pain group and(5.66±1.66)in the functional limitation group,showing statistically significant differences between the groups(P<0.05).No statistically significant differences were observed in HHS score differences or activity level differences between the two groups(P>0.05).A statistically significant difference in recovery at the final postoperative follow-up was noted between the pain group and the functional limitation group(χ2=4.828,P<0.05),with the pain group exhibiting a higher excellent and good rate of hip joint function compared to the limited mobility group;No statistically significant difference was found in the disease progression time to THA between the two groups(χ2=0.127,P>0.05).Conclusions NONFH patients undergoing THA based on pain or limited mobility as the primary medical need can achieve satisfactory clinical outcomes postoperatively.The short-term efficacy of THA is superior in patients with pain as the primary medical need compared to those with limited mobility as the primary medical need.
Keywords：Femur head necrosisArthroplastyreplacementhipTreatment outcome
Publication Date：2025-12-19
Online Publishing Date：2026-01-05(First online date of this platform, not the publication date of the document)
Pages：6( 1061-1066 )