Total hip replacement in Kuwait. Preliminary results of exeter hip prosthesis and remarks on ethnic and causative factors

ABSTRACT

This study presents clinical and radiological characteristics of 49 cemented total hip replacements of Exeter type in a series of 44 patients operated upon in Al Razi Hospital during the period 1992-1999. Different forms of secondary hip pathology accounted for most total hip replacements performed in this study Diagnostic and ethnic aspects were discussed. All patients were operated through a posterolateral approach using conventional Exeter [Howmedica] instrumentation and implant. Clinical analysis was performed using Merle d'Aubigne and Postel hip score. The method of radiological analysis is described. A single surgeon operated on all patients. During the observation period [m=3.5 years], none of the implants loosened and the average clinical score of 9.8 pts preoperatively had improved to 16.8 pts at the last follow-up. In contrast with studies done in Europe and North America, the predominant pathology among the Arabs was secondary to avascular necrosis, rheumatoid disease, or trauma. Primary osteoarthrosis was rare. Our preliminary findings are that, in the average follow-up of 3.5 years, the Exeter hip replacement gave satisfactory results. Further research is necessary to explain ethnic differences in occurrence of coxarthrosis