| Background and purposes: The stability and good three-axis movement of human hip joint are. essential elements to complete the function of lower extremities. Many diseases could cause malfunction of hip joint. Total Hip Replacement (THR) is presently one of the most effective surgeries to reconstruct the stability and mobility of hip joint, relieve pain and rectify malformation. Since the success of 62 cases of THR by Chamley in 1963 with which modern THR had began, the progress of research work on hip joint biomechanics, prosthetic material, producing technique, fixation method and implantation skill had all contributed to the improvement of therapeutic effect of THR and high survival rate of the prosthesis. THR also provided good therapeutic effect in many other hip joint diseases. Although the indications had increased according to the advancement of prosthetic design and surgical technique, the survival rate of prosthesis still could not meet clinical need. Many joint surgeons emphasize that THR should be limited to the relatively older people who has insufferable pain or severe hip joint malfunction which could not be relieved or reconstructed by other surgeries. Femoral neck fracture, osteoarthritis, rheumatoid arthritis and ankylosis, malformation, tumor of hip are all indications of THR. But reports about the differences of therapeutic effects in these hip diseases are very rare. In some follow-up studies, the incidence of complications of THR was so high that the therapeutic effect of THR was greatly affected. So it has important instructive meaning to actualize the register and follow-up system of THR for the improvement of the technique of surgery, choice and survival rate of prosthesis, decrease of complications and prognosis of the treatment.The purpose of the study is to analyze the follow-up results of primary THR. With the use of Harris hip score(1969) and clinical examination, we evaluated the therapeutic effect of THR and compared the short-term therapeutic effect of THR in different hip joint diseases to provide primary gist for the prognosis of therapeutic effect of THR in these diseases.Material and Methods: 145 THR patients who had received THR in our departmentduring 1997-2000 were followed-up with a interval of 13 months. The average duration of follow-up was 47 months (34 to 69 months). The average age is 57.5 years (33-82 years) with a mean preoperative Harris hip score (HHS) of 32.4 points. We divide these patients into 4 groups according to the primary diagnosis: fresh femoral neck fracture (FFNF), old femoral neck fracture (OFNF), osteoarthritis (OA) and femoral head necroses(FHN). The cases were retrospectively analyzed to primarily evaluate the short-term result of THR in different hip diseases (single side). There were 9 cases of Double Side Hip Disease (DSHD) with a mean age of 53.1 years in our review. Only one of them took double-side THR. The other 8 cases were operated on only one side with a mean Harris Hip score of 22.5 points preoperatively.Results: 59 out of 145 THR patients reacted to our follow-up in both 2 times. 40.7% of 145 patients provided intact follow-up information and 59.3% of patients were lost. The mean Harris score has increased to 84.7 points at the time of final follow-up. Our results showed that the mean Harris score of FFNF has increased from 21.6 points preoperatively to 89.1 points (mean age 66.2 years) at the time of final follow-up; OFNF from 37.7 points to 87.4 points (58.2 years); OA from 35.0 points to 82.5 points (56.0 years); FHN from 45.7 points to 81.0 points (53.5 years). Among the 60 hips, only one cemented FHN (1.7%) has severe pain, loss of joint mobility and ability to walk; 2 cases (3.4%) complained moderate pain and loss of joint mobility; 2 cases (3.4%) occurred dislocation postoperatively during functional exercising. One patient (1.7%) was reoperated by internal fixation 3 years after the operation because of femoral stem fracture, and the function of the hip joint is good before the fracture. No more complications occ...
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