Perioperative And Imaging Comparative Study Of DDH Treatment With HRA And THA

Objective The patients with osteoarthritis of hip dysplasia were treated with the hip surface replacement and total hip arthroplasty,collect perioperative data and imaging data and conduct comparative analysis to compare the difference in the treatment of DDH between the two surgical procedures.Methods In this study,52 cases(66 hips)with Crowe classification and type I、 II and III type were diagnosed preoperatively,from May 2006 to February 2017,with a mean age of 48.7 years.According to patients undergoing different hip arthroplasty,the HRA group included 8 males with 11 hips,18 females with 22 hips,Crowe type I type 13 cases with18 hips,type II 11 cases 13 hips,and2 type III 2 cases 2 hips.In the THA group,there were 11 males with 11 hips and 16 females with 22 hips.The Crowe type I included 13 cases with 18 hips,II with 11 cases with 13 hips,and type III 2 cases with 2 hips,collect postoperative perioperative and imaging data of two groups of patientsThrough comparison of perioperative and imaging data,the results of the treatment of DDH with HRA and THA were compared.Perioperative data included operative time,postoperative hospital stay,incision length,and intraoperative blood loss.The imaging data included the measurement by preoperative and postoperative X-ray films.The rotation center recovery index was measured by the vertical distance and horizontal distance and the direct displacement distance.The differences in the eccentricity of the reconstructed femurs were analyzed to compare the recovery of the femoral eccentricity between the two procedures.The effect of teardrops on the preoperative and postoperative changes of the trochanter was compared with the length of the equal length of both lower limbs.The AMA and BMA ratios reflect postoperative joint stability.Result 1.Average operating time in HRA group(64.72±21.70)minute,in THA group(62.45±17.80)minute,the difference was not statistically significant.Average hospital stay after surgery in HRA group(10.40±1.90)day,in THA group(12.30±2.10),the difference was statistically significant,short hospital stay in HRA patients.Average incision length in HRA group(20.51±1.72)cm,in HRAgroup(16.14±1.68)cm,the difference was statistically significant,small surgical incision in THA group.The average intraoperative blood loss in HRA group(353.00±124.30)ml,in THA group(512.00±151.70)ml the difference was statistically significant,less blood loss in HRA group.2.Changes in the vertical distance of the rotation center after surgeryin HRA group(6.14±3.87)mm,in THA group(3.24±2.71)mm;horizontal distance chaange in HRA group(2.82±1.69)mm,in THA group(0.25±2.37)mm;direct distance change in HRA group(6.96±3.87)mm,in THA group(4.34±2.08)mm;the two groups have statistically significant differences in the above-mentioned three parameters of the revolving center reconstruction.3.The femoral offsetafter surgeryin HRA group(37.96±5.55)mm,in THA group(43.17±2.19)mm,both groups had statistically significant difference before surgery.The results of femoral eccentricity reconstruction between the two groups were statistically significant.4.Comparing the distance between the preoperative and postoperative tears to the lesser trochanter and the rotation center to the teardrop in the two groups of patients,showing the change in limb length,in HRA group(9.53 ± 2.09)mm,in THA group(12.71 ± 2.27)mm,the difference was statistically significant,explain that there are differences in the degree of influence of the two factors on the two factors that change the length of the lower limbs.5.The postoperative averageof AMA/BMAin HRA group0.50±74,in THA group0.53±0.49,the difference was not statistically significant Conclusion In the HRA group,postoperative hospital stay and intraoperative blood loss were superior to those in the THA group,and THA was smaller in the surgical incision than in the HRA.The THA group was superior to the HRA group in reconstructing the femoral offset and restoring the length of the affected lower extremities.HRA can restore hip anatomy and biomechanical structure more accurately than THA.Patients can obtain similar and good hip balance ability after HRA and THA.