| BackgroundsTotal hip arthroplasty can effectively alleviate or even eliminate hip joint pain of patients and substantially improve the function of the diseased hip to recover t he better activities, futhuremore enhance the patients’quality of life. However, as the artificial prosthesis locates in vivo for extended time, more and more postoper ative complications start to appear, such as aseptic loosening of the prosthesis, infe ction, prosthesis adjacent fracture and ect on, these lead to patients with varying d egrees pain of diseased hip, the limited joint activities and even shrink shortening deformity of limp. At this time, revision of total hip arthroplasty (RTHA) is need to control the complications.ObjectiveIn this study we demonstrate the reasons for patients accepting RTHA and short-term clinical curative effects after RTHA according to analysis treatment follow up of 115 patients whose operations were performed in our department, during the past 5 years.MethodsFrom 2009.06 to 2014.10,135 patients (140 hips) accepted the RTHA at our department and we got the complete clinical and radiographic data from 115 patients (115 hips) among them, including 60 male patients and 55 female patients with the average age of 66 years old (the range from 27 to 86 years old). Among this 115 hips,72 hips involved in left side and 43 hips involved in right side. The average interval between the primary total hip arthroplasty and the revision hip arthroplasty was 8 years (the range from 0.25 to 20 years).11 hips underwent the femoral head arthroplasty and 104 hips underwent total hip arthroplasty in the primary operations. Analysis the reasons for the patients accepting RTHA after the total hip arthroplasty, Harris score, VAS score and radiological check were conducted to each patients preoperatively and at the end of the follow-up, then assess the function of hip joints of the patients and eveluate the short-term effects.ResultsThe reasons for the patients accepting revision operations in these cases included prosthesis aseptic looseness with 61 cases (53%), infection after the primary operation with 22 cases (19%), fracture adjacent prosthesis with 20 cases (17%) and dislocation of the prosthesis with 12 cases (11%). For the patients, symptom of joint pain was relieved after operation. All of the patients were visited after operations for 10 to 60 months and the average interval was 40 months. Compared with preoperative period, we found the VAS scores of the patients reduced form 7.52±1.071 to 1.10±0.892 and the average Harris scores raised from 36.06±7.518 to 85.30±6.728 in the final visit after treatment. According to the Harris score, among them 40 hips were A (100-90),63 hips were B (89-80),8 hips were C (79-70),4 hips were D(<70) and the excellent rate was 89.57%, Harris score of the patients significantly improved after operation. The P value was less than 0.05 and the results had statistical significance. There were no complications such as infection, dislocation, loosening and submersion of the prosthesis occurred. At the final follow-up, radiological evaluations for each patients showed good location of the prosthesis, ace tabular bone graft thickening and no periprosthetic osteolysis or radiolucent line.ConclusionThe main causes for the patients accepting revision operations after total hip replacement are aseptic looseness, Revision of total hip arthroplasty can effectively manage the complications and obtain the satisfactory short-term effects. Long-term effect need for further follow-up analysis. |
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