Why do Hong Kong Patients need Total Hip Arthroplasty? An analysis of 529 hips from 1998 to 2010

Abstract

Introduction: Limited updates on the demographic data and disease pattern leading to total hip replacement (THR) in Hong Kong were published in 1998 after the review on primary THR in Hong Kong Chinese from 1972 to 1997. This study aimed to review such information for patients undergoing primary THR from 1998 to 2010 in Queen Mary Hospital (QMH). Materials and Methods: Data from the prospective joint registry on all patients with primary THR done in QMH from 1998 to 2010 were reviewed. Age, sex, diagnosis, preoperative and latest follow-up Harris Hip Score (HHS) were analysed. Results: A total of 529 primary THRs were performed on 428 patients (188 males, 240 females) in the study period with clinical follow-up of at least 2 years. Their mean (± standard deviation) age was 57.7 ± 16.6 (range, 22-96) years. For males, the main aetiologies were avascular necrosis (50.2%), ankylosing spondylitis (18.8%), and post-traumatic arthritis (8.2%). For females, those were avascular necrosis (32.4%), primary osteoarthritis (20.1%), and post-traumatic arthritis (15.8%). Among the causes of avascular necrosis, alcoholic-induced (51.2%) and idiopathic (40.2%) were most common among male and female patients, respectively. The mean preoperative and latest follow-up HHS were 43.9 ± 18.4 and 90 ± 11.3, respectively. Discussion and Conclusion: Avascular necrosis is still the most common aetiology leading to THR. The underlying causes, however, are different in both sexes. The clinical result in terms of HHS was good in our patients requiring THR.