An Epidemiological Survey On Symptoms Of Chinese Traditional Medicine And The Reasons Of The Primary Total Hip Arthroplasty In Elderly Patient

ObjectiveTo investigate the syndromes of Traditional Chinese Medicine and the reasons of the primary Total Hip Arthroplasty (THA) in elderly patient (≥65years), who suffered from hip frctures、AVN(avascular necrosis of femoral head)、osteroarthritis of hip joints、DDH (development dysplasia of hip joint)、 AS(ankylosing spondylitis). To clear and definite the risk factors and prevent the dislocation after the THA operation, thanks to this investigation.MethodsAn retrospective and prospective data of the elderly aged65years and over who received primary THA operation between Jan2009and Jan2012were reviewed. The date comes from The The Second Affiliated Hospital of Guangzhou Traditional Chinese Medicine University(Guangdong Traditional Chinese Medicine Hospital), which includes the basic information of the patients and the operation, the multiple comparsion of the the dislocation and TCM symptoms. Enumeration data used X" test, measurement data used Independent sample matching t test. All the data should be tested by SPSS17.0. The standard of the statistics is P<0.05.ResultsThe quantity of the hip fracture、AVN、osteroarthritis of hip joint、 DDH、AS are581cases,25cases(4.5%) in dislocation after operation, Con-serative measurements for16cases,2open reduction, operation for7cases. Acetabulum prothesis of cement is15(60%), cementless for10(40%).In this study group, There are388cases in Youth older age groups (65-74years), include12dislocated cases (3.09%), Middle older age groups (75-89years) includes190cases,13dislocated cases (6.84%), Old older age groups (≥90years) includes3cases,0dislocated cases (0%). There are11dislocated patients (2.98%) in369cases with American Society of Anesthesiologists (ASA)1-2grade,14(6.14%) dislocated patients in212with (ASA)3-4grade. Acetabular outreach Angle is54.7°, minimum value is48.8°, maximum value66.2°.The number of THA is196cases, and10(5.1%) for dislocation,5.28%in2010,2.26%in2011. There are statistical significance in the data set above.212cases are male, including10dislocated cases(4.72%);female369cases,15dislocated cases(4.07%). Acetabular anteversion Angle is16.9°, minimum value is10.5°, maximum value26.2°.The different diameter of femoral head is22mm、26mm、28mm、32mm、36mm, dislocation rate of them are6.67%、5.88%、4.49%、3.14%、3.66%respectively. There are no statistical significance in the acetabular abduction degrees and anteversion degrees between dislocated group and non dislocated group. All the patiens in the operation suffered from hip joint capsule repair、postlateral approach. There are no statistical significance in the data set above.The epidemiological survey on sydromes of TCM:There are13cases (52.0%) in qi defficiency and blood stasis syndrome,7cases(28.0%)with the syndrome of aeeumulating blood stasis generating internal heat,5cases (20.0%) with the syndromes of Qi-stagnaneyand bloodstasis.ConclusionOld patients are almost suffer from preoperative comorbidities、more surgical risk because of older age and low immunity. So, there are more compli-cations after THA than the younger, the most one is dislocation after operation. The positive treatments including,full preparation before opera-tion, prosthesis position in the center of the hip, accurate reconstruction of the soft tissue around hip joint during perioperative period and elaborate nursing, play very impotant part in sugry. In addition, the right of Chinese medicine treats dialectical is also included. These actions could reduce the risk of the operation, and improve the quality of life after operation.