Follow-up Analysis Of Revision Of Total Hip Arthroplasty In51Cases

Objective To investigate and analysis the reasons，clinical use of rebuildingprosthesis, short-term effects and techniques of the revison of the total hiparthroplasty through the review of the operations performed in our department duringthe past10years.Methods From2002to2011,a total of66hips in61patients underwent therevisions of the total hip arthroplasty.51cases (55hips) were available for completeclinical and radiographic analysis.There were28males and23females with anaverage age of65years(range48-87years),Among55hips,25hips involved in leftside and30hips involved in right side.The average interval between the primary totalhip arthroplasty and the revision was10years (range1-22years).11hips underwentthe femoral head arthroplasty，and44hips underwent total hip arthroplasty.Accordingto Paprosky classification standard, typeⅠwas11hips, typeⅡa was8hips,typeⅡbwas14hips,typeⅡc was8hips,typeⅢa was8hips,typeⅢb was6hips. Harris scoreand radiological evaluations were conducted for each patient preoperatively and at theend of the follow-up, assess function of patients with hip joint. Review the reasons ofthe total hip arthroplasty revisions,and discuss the short-term effects and technicalconsiderations.Results The reasons of revisions in the cases were as follows:aseptic loosening(41、74.55%)，infection(8、14.55%)，dislocation of the prosthesis (3、5.45%)and fracture(3、5.45%) after the primary operation. So we can see prosthesis aseptic loosening is themain reason of revisions. The mean follow-up period was3.6years (range1-9years),The average Harris scores improved from （33.82±8.98）points preoperatively to （86.37±7.30）points at final follow-up. all have significantly improvement.According to the Harris score,among them,18hips are A(100-90),28hips areB(89-80),6hips are C(79-70),3hips are D(<70). Results significant differencebetween the two groups (P<0.05), with statistical significance.Conclusion The main cause of revision after total hip replacement is asepticloosening,followed by infection.The methods to repair and reconstruct the acetabulumand femur should be chosen properly，and the types of prosthesis are also veryimportant.Most of the patients can obtain satisfactory recent clinical results as long asthere were full preparations before operation and careful monitoring during and afteroperation.The long term effects remain to be analyzed.