Single-stage Tatol Hip Arthroplasty For Severe Hip Osteoarthritis With Aproximal Femoral Fractures

Objective:To investigate the efficacy and prognosis of single-stage total hip arthroplasty in the treatment of severe hip osteoarthritis with proximal femoral fractures.Research method:From July 2014 to October 2017,8 patients with severe end-stage hip joint disease with proximal femoral fractures of the femur were treated with single-stage total hip arthroplasty including 6 males and 2 females with an average of 65 years old(range 59 to 72)in this group;4 cases of the right femoral head necrosis accompanied with proximal femoral fracture of the right femur;3 cases of the left femoral head necrosis with the left femur proximal fracture;1 case of the left acetabular dysplasia was associated with a proximal fracture of the left femur.The average time from injury to surgery was 7 days.All 8 patients were treated with cementless extended-handle hip prosthesis.Harris hip joint scoring standard was used to score hip joint activity,which was mainly composed of pain,joint function,joint movement and walking ability.The four scores were 100 points in total,90-100 points were excellent,80-89 points were good,70-79 points were acceptable,and <70points were poor.The patient received outpatient review 1,3,6,12 months after surgery and annually.X-ray films of the hip joint were taken during the review,with the focus on the evaluation of fracture healing,prosthesis handle loosening and acetabular wear.Postoperative observation of infection,lower extremity deep venous thrombosis and other complications.Research results:All cases were followed up for the average 31months(range12 to 48 months).During the follow-up period,the cementless prosthesis did not loose or sink.The mean Harris scores had improved from 33 pre-operatively to 87 post-operatively at the end of the follow-up,the result were excellent in 3 cases,good in 5 cases.Patients can walk without crutches 3 months after the operation.X-ray at 3 to 6 months after the operation showed good fracture healing,significant impovement in hip pain and function,the quality of life has been greatly improved.Conclusion:The pain and function of the patients after single-stage total hip arthroplasty were greatly improved,and the quality of life was greatly improved.The patients were highly satisfied with the operation.Single-stage total hip arthroplasty can reduce the occurrence of various bedridden complications and the probability of death caused by bedridden complications.Single-stage total hip arthroplasty has the advantages of shortening treatment time,alleviating the pain of patients,reducing hospitalization costs,and achieving good prognosis,etc.The overall satisfaction of the patients is high,it is an effective treatment scheme.