J Korean Med Sci.  2017 Apr;32(4):581-586. 10.3346/jkms.2017.32.4.581.

Descriptive Epidemiology of Patients Undergoing Total Hip Arthroplasty in Korea with Focus on Incidence of Femoroacetabular Impingement: Single Center Study

• Lee WY
• Hwang DS
• Noh CK

• KMID: 2371441
• DOI: http://doi.org/10.3346/jkms.2017.32.4.581

Abstract

We analyzed the causes leading to total hip arthroplasty (THA), aimed to clarify the incidence of femoroacetabular impingement (FAI) among the causes, and compared the incidence in Korea with those in other countries. From January 2000 to December 2014, 1,206 hips of 818 patients who underwent primary THA at our institute were reviewed retrospectively in terms of radiographs and electronic charts. The radiographs and radiographic parameters were reviewed and measured by 2 of the authors, who are orthopedic surgeons. Patients were categorized in terms of the causes leading to THA as primary osteoarthritis (OA), rheumatoid arthritis (RA), posttraumatic arthritis, post infectious arthritis, avascular necrosis (AVN) of the femoral head, fracture of the femoral head or neck, ankylosing spondylitis (AS), developmental dysplasia of the hip (DDH), Legg-Calvé-Perthes disease (LCPD), FAI, and others. There were 32 patients (3.91%) in the primary OA group, 41 (5.01%) in the RA group, 84 (10.27%) in the posttraumatic arthritis group, 39 (4.77%) in the post infectious arthritis group, 365 (44.62%) in the AVN group, 39 (4.77%) in the fracture group, 21 (2.57%) in the AS group, 52 (6.36%) in the DDH group, 71 (8.68%) in the LCPD group, 52 (6.36%) in the FAI group, and 22 (2.69%) in the "˜other' group. The causes leading to THA in Korea differ from those in Western countries. FAI could be causes of severe secondary OA that requires THA in Korea, therefore symptomatic FAI should not be neglected.

Keyword

Hip; Osteoarthritis; Total Hip Arthroplasty; Femoroacetabular Impingement; Incidence

Figure

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  Fig. 1 The graph shows that the procedural number of total hip arthroplasties from 2000 to 2014 increased consistently.

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  Fig. 2 The graph shows the changes of causes leading to THA. THA = total hip arthroplasty, AVN = avascular necrosis, LCPD = Legg-Calvé-Perthes disease, DDH = developmental dysplasia of the hip, FAI = femoroacetabular impingement, RA = rheumatoid arthritis.

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  Fig. 3 Anteroposterior radiographs illustrate the case of a 62-year-old female patient who had primary OA of both hips. (A) The radiograph was taken before THA. Lateral center-edge angle, sharp angle, and acetabular roof obliquity of right hip was 37.2°, 35.8°, and 8.6°, respectively. Left hip was 43.5°, 35.2°, and 7.0°, respectively. (B) The radiograph was taken after THA to treat primary OA. THA = total hip arthroplasty, OA = osteoarthritis.

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  Fig. 4 Anteroposterior radiographs illustrate the case of an 85-year-old female patient who had secondary OA caused by Cam type FAI of left hip. (A) Preoperative radiograph shows typical pistol grip deformity on left hip. (B) The radiograph was taken after THA. THA = total hip arthroplasty, FAI = femoroacetabular impingement, OA = osteoarthritis.

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  Fig. 5 Anteroposterior radiographs illustrate the case of a 76-year-old female patient who had secondary OA caused by Pincer type FAI of left hip. (A) Preoperative radiograph shows typical acetabular protrusion on right hip. (B) The radiograph was taken after THA. THA = total hip arthroplasty, FAI = femoroacetabular impingement, OA = osteoarthritis.

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