Clinical Research On Early Complication Associated With Total Hip Replacement

Object: To explore the causes and related factors of the early complicationsassociated with total hip replacement (THR), and summarise some measures to prevent and treat them, and reduce the ocurrence of complications.Methods: 1208 cases of primary total hip replacement operation were analyzedretrospectively, including 520 male cases and 688 female cases, whose ages range from 25 to 83 years. The statistical indexes include sex, age, body weight, other system disease, previous hip joint operation, limb shorten, anesthesia, operative time, operative approach, acetabulum of anteverted angle and abducens angle, the height of the femoral head center, prosthetic fixation,blood transfusion,postoperative functional exercise, antithrombotics, complication. Standardized database was built and analyzed by SPSS (version 11.5). First, single factor analysis on ages was made by Independent Samples Test, and other factors by Chi-Square tests. Then, regression analysis was made to the factors that were filtered with Binary Logistic Regression.Results: 194 cases had early complications and the total incidence rate was16.1%. Among these cases, 93 cases had deep venous thrombosis, 44 cases had dislocation of hip joint, 11 cases of Injury to nerve, and 17 cases of heterotopic ossification. Besides there were 10 cases of femur fracture, 7 cases of deep part infection, 2 cases of Injury to blood vessel, 2 cases of pulmonary infection, 4 cases of stress ulcer, 3 cases of electrolyte disturbances and 1 case of cardiac arrest.Age, other system diseases and previous hip joint operation were correlated with early total complications o<0.05). Age, other system diseases, anesthesia, prosthetic fixation, blood transfusion, postoperative functional exercise and antithrombotics were correlated with THR early concomitant DVT (p<0.05). Previous hip joint operation, operative approach, acetabulum ofanteverted angle and abducens angle, the height of the femoral head center were correlated with THR early concomitant dislocation (p<0.05).Conclusions:1. Older age, hypertension or diabetes, Previous hip joint operation are the risk factors of complications in the early period after THR.2. Older age, hypertension or diabetes, general anesthesia, fixation of bonecement, whole blood transfusion are the risk facters for early concomitant DVTfollowing THR, while postoperative functional exercise and antithrombotics are the protective factors for DVT.3. Keeping acetabulum of anteverted angle (10°~20°), abducens angle (40°~ 50°) and the height of the femoral head center (<30mm) , restoring the joint capsule and keeping tension and balance of parenchyma around the joint can obviously decrease the rate of dislocation .4. The occurrence rate of early complications can be reduced by the methods such as dealing with perioperatively treatment carefully, effectively controlling the chronic diseases, efficient evaluation before surgery, precise manipulation, and the postoperative prophylactic treatment and nursing.