Functional outcome of non-cemented total hip arthroplasty for avascular necrosis in adults of below 50 years age group

Background: Avascular necrosis (AVN) of the femoral head is a progressive disorder causing joint destruction and functional impairment, particularly in younger adults. Total hip arthroplasty (THA) is the standard treatment for advanced AVN and non-cemented prostheses are increasingly preferred because of their biomechanical advantages and long-term stability. This study evaluated the functional outcomes of non-cemented THA in AVN patients under 50 years of age. Methods: A prospective observational study was conducted at the National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh, from September 2021 to March 2024. Thirty-four patients with late-stage AVN (Ficat & Arlet Stage III and IV) underwent non-cemented THA. Functional outcomes were assessed preoperatively and postoperatively using the Harris Hip Score (HHS), range of motion (ROM), pain severity, walking distance and need for support. Data were analyzed using SPSS version 25, with p<0.05 considered statistically significant. Results: The mean age was 35.50±7.01 years and 73.53% were male. Mean HHS improved significantly from 37.12 preoperatively to 91.44 postoperatively (p=0.001), with 61.8% achieving excellent outcomes (HHS >90). Significant improvements were observed in pain severity, limping, support dependency and walking distance (p=0.001). ROM also improved significantly, with 64.71% achieving a postoperative ROM of 161°–210°. Complications were minimal, including superficial surgical site infection in 5.88% and limb length discrepancy in 2.94%. Conclusions: Non-cemented THA provides significant pain relief and improvement in mobility, ROM and functional outcomes in AVN patients under 50 years, with minimal complications, supporting its use in younger active patients.