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International Medical Scientific Journal        Issue-3 

10.5281/zenodo.5634147 

9 

    



Art of Medicine           Volume-1 

International Medical Scientific Journal        Issue-3 

10.5281/zenodo.5634147 

10 

 

Art of Medicine International Medical Scientific journal 

 

Founder and Publisher Pascual Izquierdo-Egea 

Published science may 2021 year. Issued Quarterly. 

Internet address: http://artofmedicineimsj.us 

E-mail: info@artofmedicineimsj.us 

11931 Barlow Pl Philadelphia, PA 19116, USA +1 (929) 266-0862 

 

 
  



Art of Medicine           Volume-1 

International Medical Scientific Journal        Issue-3 

10.5281/zenodo.5634147 

11 

COMPARATIVE ANALYSIS OF SEPARATE RESULTS OF 

ARTHROPLASTY FOR ASEPTIC NECROSIS OF THE FEMORAL HEAD 

Akramov Vohid Rustamovich 

Bukhara State Medical Institute, Bukhara, Uzbekistan 

Abstract. Objective: Improving the results of arthroplasty in aseptic necrosis 

of the femoral head (ANFH). Materials and Methods: We studied the quality of life 

of patients according to the scale developed by us; we examined patients before and 

after treatment in 172 patients. The patients were of working age from 20 to 65 years 

old. In this system, 6 clinical parameters were used on a 5-point scale, the clinical 

result was assessed by the analysis of the sum of points. Results: Analysis of the 

results of surgical treatment of patients with ANFH showed the prevalence of the 

proportion of good results in patients of the main group in 45 (82.6%) cases versus 

the control group - 40 (73%) and a decrease in unsatisfactory results to 1 (1%) case in 

patients of the main group against the control - 2 (3%). 

Keywords: separate results, endoprosthetics, aseptic necrosis of the femoral 

head. 

          Introduction. Aseptic necrosis of the femoral head is one of the most pressing 

problems of modern orthopedics, which leads to severe pain syndromes, limited joint 

function, significant economic costs and increased mortality [1, 2, 8, 9, 10, 12]. 

Clinical and radiological signs of degenerative-dystrophic diseases of large joints are 

found in 55 - 65% of cases in people over 60 years old and in about 80% of people 

over 75 years old. Many authors have proven that early diagnosis, complex and 

specific treatment of ANFH, depending on the stage of the disease, are the key to 

successful treatment and reduce complications [3, 4, 5, 6, 7, 11]. 

As studies of recent years show, ANFH is a polietiologic disease, with a large 

role playing, general and local factors of them: trauma, alcohol intoxication and those 

taking steroid drug therapy [13, 15, 16, 17, 18, 19, 21]. 

The authors describe in patients who have suffered fractures of the femoral 

neck and traumatic dislocation of the femoral head in the near and long-term, ANFH 



Art of Medicine           Volume-1 

International Medical Scientific Journal        Issue-3 

10.5281/zenodo.5634147 

12 

develops. These patients have obstruction of the blood vessels feeding the femoral 

head, which leads to degenerative-dystrophic changes characteristic of ANFH [14, 

20, 22, 23, 24, 25, 26]. 

Materials and methods. We studied the quality of life of patients according to 

the scale developed by us; we examined patients before and after treatment in 172 

patients. The patients were of working age from 20 to 65 years old. In this system, 6 

clinical parameters were used on a 5-point scale, the clinical result was assessed by 

the analysis of the sum of points.  

Results. According to our assessment of the quality of life, good results were 

in the range from 15 to 22 points, satisfactory - from 8 to 14; unsatisfactory was 

assessed by the sum from 0 to 7 points. Summarizing the scores obtained, we 

evaluated the effectiveness of the treatment and presented them as a percentage, 

which reflected the difference between the post-treatment increase in the score. We 

took the initial state of the patient as 100%. After surgery, an increase in the score of 

up to 30% of the initial patient scores before surgery was noted (Table 1). 

Table 1 

Criteria for assessing the quality of life of patients with ANFH 

Pain Function Emotion

al 

percepti

on 

Necessity of 

means of 

rehabilitatio

n and 

support, 

(orthoses, 

cane) 

Ability to 

walk / 

perform 

an action 

with the 

upper 

limb 

Gait 

disorder / 

ability to 

lift and 

carry 

weights 

Poin

ts 

No  no 

restrictio

ns  

enthusias

m  

No no 

restriction

s  

Norm 5  

transient 

weak 

transient 

weak 

transient 

weak 

transient 

weak 

transient 

weak 

transient 

weak 

4  

weak  restrictio

n in 

precise 

moveme

nts 

Satisfacti

on 

brace limited minimal 

cosmetic 

disturbance

s 

3  

transient transient transient transient transient transient 2  



Art of Medicine           Volume-1 

International Medical Scientific Journal        Issue-3 

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moderate  moderate moderate moderate moderate moderate 

moderate partial 

incapacit

y 

acceptabl

e  

one cane or 

crutch 

a 

housewife 

maximum 

cosmetic, 

minimum 

physical 

difficulties  

1  

significa

nt 

complete 

inability 

unaccept

able  

two canes or 

crutches  

need for 

outside 

help  

absent  0  

 

To study the results of treatment, comparative immediate results of treatment 

were carried out in patients with ANFH before and after 1 month. after surgical 

treatment. Comparative results of treatment in patients with ANFH before and 1 

month  after surgical treatment (table 2).                           

Table 2 

Criteria for assessing the quality of life of patients with ANFH 

Criteria for 

evaluation 

Before treatment (n = 110) 

patients 

After treatment, one month 

later (n = 110) patients 

 The main Control The main Control 

Pain 1 1,0 2,5 2,0 

Function    1,5 1,5 2,5 2,0 

Emotional 

perception 

1,5 1 1,5 1,5 

The need for 

rehabilitation 

and support 

(orthoses, 

cane) 

1,0 1,0 2,5 2,5 

The ability to 

walk / perform 

an action with 

the lower limb 

1,5 1,5 2,5 2,0 

Gait disorder / 

ability to lift 

and carry 

weights 

1,5 1 2,5 2 

Points total 8 7 14 12 

 



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From table 2 it can be seen that before the operation, that in ANFH patients 

before the operation, pain was noted - in the main group, 1 points, in the control 

group, 1 points. After the operation, one month later, it became 2.5 points in the main 

and 2 points in the control. 

Before the operation, the patients had impaired mobility function of varying 

severity after the operation, the dysfunction recovered before the operation in the 

main group, 1.5 points and the control group were also 1.5 points. After the 

operation, one month later, it became 2.5 points in the main group and 2 points in the 

control group.  

Before the operation, the patients had emotional perception in the main group, 

it was 1.5 and the control group was also 1.0 points. After the operation, one month 

later, it became 1.5 points in the main group and 1.5 points in the control group. 

Before the operation, the patients had a need for means of rehabilitation and support, 

(orthoses, canes) in the main group, 1.5 points were noted, and in the control group, 

they were also 1.0 points. After the operation, one month later, it became 2.5 points 

in the main group and 2.5 points in the control group. Before the operation, the 

patients had an insignificant ability to walk, to perform the action with the upper limb 

before the operation in the main group, 1.5 points were noted and in the control 

group, also 1.5 points. After the operation, one month later, it became 2.5 points in 

the main group and 2 points in the control group. Before the operation in patients, the 

ability to lift and carry weights before the operation in the main group was 1.5 and 

the control group was also 1.0 points. After the operation, one month later, it became 

2.5 points in the main group and 2 points in the control group. The average score 

before treatment in the main group was 8, in the control group. After the treatment, it 

became the main group of 14, and in the control group - 12 points. The presence of 

persistent pain was the main indication for surgery in both groups; after surgical 

treatment, pain decreased most in the main group compared to the control group, 

which shows a good efficacy of surgical treatment of hip joint. 



Art of Medicine           Volume-1 

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We present the comparative results of treatment in patients with ANFH after 

treatment at 3.6 months and one, two years (table 3).  

Table 3 

Comparative results of treatment in patients with ANFH after surgical 

treatment 

                                                            

Criteria for 

evaluation 

3 months 6 months 1 year 2 year 

 The 

main 

Cont

rol 

The 

main 

Cont

rol 

The 

main 

Cont

rol 

The 

main 

Cont

rol 

Pain 3 2,5 3,5 3 4 3 4,0 4,0 

Function    3 2,5 4 3,0 4,0 3 4 4,0 

Emotional 

perception 

3 3 3 3 3 4,0 4 3 

The need for 

rehabilitation and 

support (orthoses, 

cane) 

3,0 3 3,5 3,0 4 4 4 4 

The ability to walk 

/ perform an action 

with the lower 

limb 

2,5 2 3 3 3 2,5 3,0 3,0 

Gait disorder / 

ability to lift and 

carry weights 

2,5 2 3 2,0 3 2,5     3,0 3,0 

Points total 17 15 20 17 21 19 22 21 

 

Table 3 shows that in patients after surgery, pain was noted in the main group: 

after 3 months - 3, 6 months - 3.5, 1 year - 4 and 2 years - 4 points. In the control 

group: after 3 months - 2.5, 6 months - 3.0, 1 year - 3 and 2 years - 4 points. 

After the operation, dysfunction was observed in the main group: after 3 

months - 3, 6 months - 3.5, 1 year - 4 and 2 years - 4 points. In the control group: 

after 3 months - 2.5, 6 months - 3.0, 1 year - 3 and 2 years - 4 points. 

After the operation, the patients had emotional perception in the main group: 

after 3 months - 3, 6 months - 3.0, 1 year - 3 and 2 years - 4 points. In the control 

group: after 3 months - 3.0, 6 months - 3.0, 1 year - 4 and 2 years - 3 points. 



Art of Medicine           Volume-1 

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After the operation, the patients noted the need for rehabilitation means and 

support (orthoses, canes) in the main group: after 3 months - 3.6 months - 3.5, 1 year 

- 4 and 2 years - 4 points. In the control group: after 3 months - 3.0, 6 months - 3.0, 1 

year - 4 and 2 years - 4 points. 

After the operation, the patients had the ability to walk, perform an action with 

the upper limb, emotional perception in the main group: after 3 months - 2.5, 6 

months - 3.0, 1 year - 3 and 2 years - 3 points. In the control group: after 3 months - 

2.0, 6 months - 3.0, 1 year - 2.5 and 2 years - 3 points. 

After the operation, the patients had a gait disorder, the ability to lift and carry 

weights in the main group: after 3 months - 2.5, 6 months - 3.0, 1 year - 3 and 2 years 

- 3 points. In the control group: after 3 months - 2.0, 6 months - 2.0, 1 year - 2.5 and 2 

years - 3 points. 

The average score before treatment in the main group: after 3 months - 17, 6 

months - 20.0, 1 year - 21 and 2 years - 22 points. In the control group: after 3 

months - 15.0, 6 months - 17, 1 year - 19 and 2 years - 21 points. From these data, we 

can say that in patients in the postoperative period after 6 and 12 months, there is an 

improvement in the results of treatment: a decrease in pain, deformity and an increase 

in the amplitude of joint movement and an improvement in limb function (Table 4). 

                        Table 4 

Results according to the scale developed by us 

Scale score  Основная  

группа 

Контрольная 

группа  

Количество 

больных 

Good 45 (82,6%) 40 (73%) 85 (77%) 

Satisfactory  9 (16,4%) 13 (24%) 22 (20%) 

Unsatisfactory 1 (1%) 2 (3%) 3 (3%) 

Total 55 (100%) 55 (100%) 110 (100%) 

 

Table 4 shows that in patients with ANFH, good results were obtained in the 

main group in 45 (82.6%), in the control group in 40 (73%). Satisfactory in the main 

group in 9 (16.4%), in the control group in 13 (24%). Unsatisfactory in the main 



Art of Medicine           Volume-1 

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group in 1 (1%), in the control group in 2 (3%). Compared to the main and control 

groups, the results of treatment after arthroplasty in the main group are good results 

82.6%, in the control group 73%, these data show the effectiveness of surgical 

treatment in the main group. 

Conclusion. The use of the developed method of hip arthroplasty in ANFH 

against the background of severe osteoporosis promoted good integration of the 

prosthesis with the bone, leading to an improvement in the functional capacity of the 

joint and lengthening the life of the endoprosthesis. 

Analysis of the results of surgical treatment of patients with ANFH showed the 

prevalence of the proportion of good results in patients of the main group in 45 

(82.6%) cases versus the control group - 40 (73%) and a decrease in unsatisfactory 

results to 1 (1%) case in patients of the main group against the control - 2 (3%). 

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