Short-term Clinical Outcome Of Total Hip Replacement In Patients With Advanced Osteonecrosis Of The Femoral Head

Objective: The aim was to study the short-term postoperative limb function and imaging of hip prosthesis following total hip arthroplasty(THA)in patients with advanced osteonecrosis of femoral head.Methods: Clinical data of 35 patients(51 hips)with advanced osteonecrosis of femoral head(experimental group)for more than ten years treated with total hip arthroplasty from January 2015 to January 2017 were retrospectively analyzed.The control group included 35 patients(53hips)with osteonecrosis of femoral head for less than five years(control group)treated at the same time.There was no significant difference in gender,age,BMI and other general data between the two groups(P >0.05).However,the differences in preoperative Harris score of hip joint and the course of osteonecrosis of femoral head were statistically significant(P <0.05).Operative time,intraoperative blood loss and hospital stay were recorded.During the followup period,hip joint function was evaluated by Harris hip score,Self-Administered Patient Satisfaction Scale(SAPS)and maximum range of motion at the same time.The orthotopic pelvic X-ray was reviewed to observe and measure the position of the prosthesis,and the incidence of surgical complications was recorded.Results: 1.Preoperative analysis indicated that the experimental group had a lower Harris score and a longer course of disease.2.Intraoperative analysis indicated that the patients in the experimental group had a longer operation time and a larger amount of intraoperative blood loss.And in the experimental group,the vertical distance to the femoral head rotation center was larger,larger acetabular cups were used and the screws were used more frequently.However,there were no significant differences in the horizontal distance to the femoral head rotation center,femoral eccentricity and femoral head prosthesis size between two groups.3.Postoperative analysis indicated that the patients in the experimental group were hospitalized for a longer time and had lower maximal range of motion after surgery.However,compared with the control group,there was no significant difference in Harris score and satisfaction score.Conclusion: 1.Compared with the patients with osteonecrosis of femoral head for less than five years,the patients with the same diseases for more than ten years received a similar functional score and satisfaction score two years after surgery,but the maximum range of motion of the joints was smaller.2.Imaging analysis indicated that the acetabular cup was placed in a higher position,the acetabular cup was used in a larger size and more screws were used in the patients with osteonecrosis of femoral head for more than ten years.