The Short-term Foltow-up Of Total Hip Arthroplasty In The Treatment Of Avascular Necrosis Of The Femoral Head

Background:Avascular necrosis of the femoral head is a clinical common highlydisabling diseases. In the existing literature statistics, there are aboutmore than60kinds of factors can cause ANFH. ANFH is always thecommon consequence of diseases which block blood circulation inosseous tissue eventually. According to the causes, ANFH can beenroughly divided into two categories: the traumatic and non traumatic.Andthe patients who belong to the traumatic group always have a history ofhormone treatment or excessive intake of alcohol. In the treatment ofANFH, diagnosis is still a priority, followed by clinical staging of ANFHand the cause of necrosis, To select the best treatment, the age of patient,general condition of the body, unilateral or bilateral hip damage shouldalso been used as the reference indexes. In recent years, experts bothdomestic and abroad have made an active exploration of the treatment ofANFH, and achieved some improvements. Palliative surgeries which aimto persist hips are always used to treat the patients with early ormetaphase ANFH, THA is always received by the patients with terminalstage (Ⅲ, Ⅳ) of ANFH as an effective treatment Purpose:To investigate short-term results of total hip arthroplasty in thetreatment of avascular necrosis of the femoral head.Method:Between Jan.2010and Dec.2012,57patients(76hips) had beenfollowed up.30patients（41hips）for male and27patients（45hips）forfemale.The mean average age is52.22years old (26Y-75Y) when carriedon THA.The followed up continued11-47month with an average of24.37month. Time distribution of the operations,14cases in2010,4cases in2011,39cases in2012. Separated by the etiology,20cases ofsteroid-induced,29cases of alcoholic,2cases of traumatic, and6casesof idiopathic. Separated by the implant fixation type,12cases(14hips)were mixed type,45cases (62hips) were uncemented type. Clinicaloutcomes were evaluated according to Harris score as the main indicator,the secondary indicators was WOMAC score.Result：At the end,56cases (76hips) had been followed up.The averageHarris score increased from preoperative46.47to95.33points (range55.3-100).“excellent” for39hips (68.42%);“good” for8hips (14.03%)，The excellent and good rate82.46%。The Harris score for cemented team89.76points,for uncemented team90.45points (P=0.083>0.05);TheWOMAC score for cemented team92.21points,for uncemented team93.66points (P=0.092>0.05). The statistics show that the result of thealmost identical.Conclusion:1.There are no significant differences between the two types inmixed and uncemented.2.Short-term efficacy is no significant difference total hiparthroplasty for the treatment of various causes necrosis of the femoralhead.3.The result of the THA in the treatment of avascular necrosis of thefemoral head in our hospital turned to be satisfactory.